A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse. Am J Obstet Gynecol 2005 May;192(5):1649-54
Date
05/20/2005Pubmed ID
15902172DOI
10.1016/j.ajog.2005.02.061Scopus ID
2-s2.0-20644448016 (requires institutional sign-in at Scopus site) 108 CitationsAbstract
OBJECTIVE: This study was undertaken to compare outcomes after anterior colporrhaphy with and without a solvent dehydrated cadaveric fascia lata graft.
STUDY DESIGN: A total of 162 women were enrolled in a prospective, randomized trial that evaluated the impact of a solvent dehydrated cadaveric fascia lata patch on recurrent anterior vaginal prolapse. Subjects were randomly assigned to standard colporrhaphy with or without a patch. Before and after surgery, subjects were evaluated by both the Baden-Walker and pelvic organ prolapse quantification systems. "Failure" was defined as stage II anterior wall prolapse or worse.
RESULTS: Of 154 women randomly assigned (76 patch: 78 no patch), all underwent surgery and 153 (99%) returned for follow-up. Sixteen women (21%) in the patch group and 23 (29%) in the control group experienced recurrent anterior vaginal wall prolapse (P = .229). Only 26% of all recurrences were symptomatic. Concomitant transvaginal Cooper's ligament sling procedures were associated with a dramatic decrease in recurrent prolapse (odds ratio [OR] 0.105 , P < .0001).
CONCLUSION: Solvent dehydrated fascia lata as a barrier does not decrease recurrent prolapse after anterior colporrhaphy. Transvaginal bladder neck slings were associated with a significant reduction in the risk of recurrent anterior wall prolapse.
Author List
Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y, Sand PKMESH terms used to index this publication - Major topics in bold
AgedDehydration
Fascia Lata
Female
Gynecologic Surgical Procedures
Humans
Incidence
Middle Aged
Prospective Studies
Secondary Prevention
Solvents
Treatment Outcome
Uterine Prolapse
