Abdominal Sacrocolpopexy: The Use of Cadaveric Allograft to Support the Vaginal Apex Shoes Long-Term Efficacy
Dr. Edward J. Stanford
Centralia, Illinois

OBJECTIVE: There are several materials available to the surgeon to use in supporting the vagina when performing an abdominal sacrocolpopexy.  This paper reports the use of cadaveric allograft with 18-month follow-up results. 

METHODS:   Twenty patients met criteria for retrospective review having undergone an abdominal sacrocolpopexy.  At least 18-months of follow-up (12-22 months) was available on 12 patients.  The patients presented preoperatively with prolapse of the vagina and were given informed consent for repair by abdominal sacrocolpopexy along with concomitant pelvic reconstructive procedures.  The patients all consented for use of a cadaveric allograft after the use of alternative materials such as mesh or fascia lata were discussed.  POP-Q data pre- and post-operatively were obtained.

RESULTS: All repairs were successful with no failures of support of the apex of the vagina.  The average age of the patients was 65 years (range 54-75 years).  Estimated blood loss was 100 cc (range <50-150cc).  Concomitant pelvic reconstructive surgeries were performed in all but 1 patient.  One patient underwent an abdominal hysterectomy at the time of the colpopexy.  No infections were noted.  One suture erosion was noted and treated in the office.  One patient required repair of a recurrent cystocele and recurrent stress incontinence with a vaginal paravaginal repair and sling procedure.  Detrusor instability was diagnosed in 2 patients both of whom had undergone a Burch colposuspension.  POP-Q results confirm good post-operative long-term support.

CONCLUSIONS: When performing an abdominal sacrocolpopexy the use of a cadaveric allograft is an effective alternative material offering good long-term success at 1 year or greater follow up.