Abstract
Abstract
Objective:
By 80 years of age, 11.1% of women are expected to undergo pelvic organ prolapse (POP) surgery and one-third of women are expected to undergo reoperation. The “gold standard” procedure is sacrocolpopexy, which uses a graft to support the vaginal apex to the ligaments of the sacrum. The conventional graft (polypropylene mesh) has been associated with dyspareunia, persistent pelvic pain, and increased mesh erosion. In an effort to combat these complications, a noncrosslinked acellular dermal matrix (ADM; STRATTICE™ Reconstructive Matrix, LifeCell, an ACELITY Company, Bridgewater, NJ) was utilized for this study.
Materials and Methods:
Sacrocolpopexy, with ADM, was used for 9 patients between January 2011 and December 2013. The patients completed Pelvic Floor Distress Inventory-20 (PFDI-20) and pelvic floor impact questionnaires and reported on postsurgical outcome satisfaction. Patient satisfaction with clinical outcomes was assessed. Biopsies of the sacrocolpopexy were performed and tissue samples were sent for histology testing if a patient returned for another procedure.
Results:
During sacrocolpopexy, an ADM was trimmed to fit each patient's anatomy, attached to the vaginal cuff or cervix using sutures, and, when possible, incorporated with the round ligament on each side. The entire sacrocolpopexy was kept in the retroperitoneal space. The postoperative PFDI-20 average score was 25.47 ± 29.68. The postsurgical pelvic floor impact score was, on average, 98%. Patient reported satisfaction with postsurgical outcomes ranged from 70% to 100%. Histology testing showed dense and loose connective tissue with blood vessels, and fibroblast cells and minimal inflammation.
Conclusions:
Other specialties have adopted the use of ADM for defect repairs and breast reconstruction. ADMs can also be used in sacrocolpopexy. (J GYNECOL SURG 33:248)
Get full access to this article
View all access options for this article.