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- Title
Solvent-dehydrated dermal allograft (AXIS™) augmented cystocele repair: longitudinal results.
- Authors
Juma, Saad; Raheem, Omer
- Abstract
Introduction and hypothesis: Surgical repair options for pelvic organ prolapse (POP) include native tissue, allograft, xenograft, and synthetic grafts. Solvent-dehydrated dermal allograft (SDDG) has an improved safety profile. We evaluated the long-term safety and efficacy of SDDG use for cystocele repair. Methods: A total of 184 patients completed a minimum follow-up of 12 months. Incontinence Impact Questionnaire (IIQ), Urogenital Distress Inventory (UDI), and Visual Analogue Scale (VAS) were used pre and post operatively. Recurrent cystocele grade ≥ II and/or repeat cystocele repair were considered objective failure. Results: Preoperatively, 17 patients (10%) had grade IV cystocele, 87 (47%) grade III, 70 (38%) grade II, and 10 (5%) grade I. All patients underwent SDDG cystocele repair with/without vaginal sling and/or POP repair and/or hysterectomy. Mean hospital stay was 0.58 days (range 0-4), mean estimated blood loss (EBL) was 111 mL, and mean length of Foley catheterization was 1.85 days (range 0-28). Postoperatively, 113 patients (64%) had no recurrent cystocele, 34 (19%) had grade I, 19 (11%) grade II, and 10 (6%) grade III cystocele. None had grade IV cystocele. Nineteen patients (10.3%) underwent repeat cystocele repair. Thirty-eight patients (21.6%) had postoperative recurrence (recurrent cystocele grade ≥ II and/or repeat cystocele repair). Dermal allograft related adverse events included 1 (0.5%) allograft vaginal exposure, dyspareunia 1 (0.5%), and transient hydronephrosis in 1 (0.5%). There were no vascular, vesical, visceral or neurological injuries. Conclusions: These results indicate that SDDG augmented cystocele repair is a safe procedure, with low morbidity, and it's success is comparable to other techniques.
- Subjects
OPERATIVE surgery; PELVIC organ prolapse; TISSUES; HOMOGRAFTS; XENOGRAFTS
- Publication
International Urogynecology Journal, 2017, Vol 28, Issue 8, p1159
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-016-3245-8