VAGINAL PARAVAGINAL REPAIR WITH THE USE OF PORCINE DERMIS

A.C. Steinberg, I.A. Oyama, M. Feloney, M.H.T. Grody, A.S. Holzberg, J. Maccarone

UMDNJ/RWJMS-Camden, Cooper University Hospital, Camden, NJ

OBJECTIVE: This study was undertaken to describe the objective outcomes following a vaginal paravaginal repair with the use of porcine dermis.

MATERIALS AND METHODS: This was a retrospective study looking at 81 patients who received a vaginal paravaginal repair using porcine dermis in 2002 for symptomatic pelvic organ prolapse.  The graft was cut into a 6 x 12cm trapezoid. The Baden-Walker classification was used for staging pelvic organ prolapse.  Comparisons were made between the preoperative values and the most recent postoperative exam by using the Mantel-Haenszal Mean Score.

RESULTS:  The mean age of the patients was 58.1 +/-12.5 years.  Patients had a mean follow up of 8.5 +/-7.01 months. Preoperatively 54% (44/81) had second degree and 44% (36/81) had third degree prolapse of the anterior vaginal wall.  Postoperatively there was a decrease in anterior compartment prolapse (p <.0001).  69% of patients had no prolapse, 26% had first degree and 4.9% had second degree prolapse on the most recent postoperative exam.  When analyzed separately, each preoperative stage of prolapse showed a significant improvement postoperatively (p<.0001).  Age, hormone replacement therapy and medical conditions such as hypertension, diabetes, and hypothyroidism did not influence outcome.

CONCLUSION: Vaginal paravaginal repair with the use of porcine dermis is effective in correcting anterior compartment defects.  

Key Words: vaginal paravaginal repair, porcine dermis, anterior compartment prolapse

Disclosure – Speakers Bureau: A.S. Holzberg, Pfizer; Proctor, BARD, Inc.; J. Maccarone, Pfizer, Proctor, BARD, Inc.; Consultant: A.S. Holzberg, Boston Scientific.