Female UrologyGenital Prolapse Repair Using Porcine Skin Implant and Bilateral Sacrospinous Fixation: Midterm Functional Outcome and Quality-of-Life Assessment
Section snippets
Material and Methods
From May 2001 to June 2006, all women with Stage III or IV genital prolapse referred to the Gynecology Department of Tenon Hospital for reconstructive pelvic surgery were included in this study, with the exception of patients who underwent laparoscopy. The study population consisted of 101 women. All the patients underwent augmentation of the genital prolapse with a total hammock of porcine skin collagen implant (Pelvicol).
All women underwent pelvic examination to evaluate the stage of genital
Epidemiology and Surgical Findings
The demographic and clinical characteristics of the 101 patients are listed in Table 1. Nearly two thirds of the patients had cardiovascular disorders requiring anticoagulant treatment. Surgery was feasible in every case and took a median of 112 minutes (range 40-310), including the operating time for hysterectomy and urinary incontinence treatment (transobturator tape).
The overall intraoperative complication rate was 4.9% (5/101). One vessel injury of the infundibulopelvic ligament occurred
Comment
The results of the present study have demonstrated that the preoperative scores of validated questionnaires are potential tools to predict the outcome after genital prolapse repair. Moreover, we found that the porcine skin collagen implant and bilateral sacrospinous fixation offer a high midterm success rate.
In addition to the anatomic results, the main goal of surgical management of genital prolapse is to improve patients' QOL. In the present study, a significant improvement in the POPDI-6,
Conclusions
The results of the present study support the use of a biologic implant with bilateral sacrospinous fixation for the effective treatment of high-grade genital prolapse with high objective and subjective success rates. Validated questionnaires appear to be not only relevant in evaluating the effect of surgery, but also a potential useful tool to predict the outcome after genital prolapse repair. However, these assertions require additional studies for confirmation.
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