Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.14/139937
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- Title
- Site-specific prolapse surgery. II. Vaginal paravaginal repair augmented with either synthetic mesh or remodelling xenograft
- Related
- International urogynecology journal, Vol. 22, Issue 5, (2011), p.601-609
- DOI
- 10.1007/s00192-010-1346-3
- Publisher
- Springer
- Date
- 2011
- Author/Creator
- Reid, Richard I
- Author/Creator
- Luo, Kehui
- Description
- Introduction and hypothesis: This study aims to answer the question, "Does tissue augmentation improve the mechanical repair of displacement cystourethrocoele?" Methods: A retrospective cohort study comparing 108 bridging graft vaginal paravaginal repairs (89 tissue-inductive xenografts and 19 polypropylene mesh) to 59 native tissue historical controls was conducted. Main outcome measures were same-site prolapse recurrence and time to failure. Initial reliability was evaluated by chi-squared test, 10-year durability by Kaplan-Meier survival analysis and risk factors by Cox regression. Results: Late recurrence was 17.7% lower with augmentation (logrank test χ2=8. 4, p value=0.0038<0.05, adjusted regression analysis χ2=2.94;p value=0.0866 <0.10), implicating collagen degeneration in repair failure. Conclusions: Rebuilding the pubocervical septum, from arcus to arcus and pubic ramus to pericervical ring, satisfies the mechanical but not the metabolic hernia principles. Bridging grafts simplify technical repair (reducing prolapse persistence from 10.2% to 4.6%), and also rejuvenate adjacent connective tissue (reducing late recurrence from 22.6% to 4.9%).
- Description
- 9 page(s)
- Subject Keyword
- Connective tissue pathology
- Subject Keyword
- Cystocoele aetiology
- Subject Keyword
- Hernia/therapy
- Subject Keyword
- Reconstructive surgical procedures/pelvis/methods
- Subject Keyword
- Tissue engineering bioprosthesis
- Subject Keyword
- Vaginal paravaginal repair/treatment outcome
- Resource Type
- journal article
- Organisation
- Macquarie University. Dept. of Statistics
- Identifier
- http://hdl.handle.net/1959.14/139937
- Identifier
- ISSN:0937-3462
- Identifier
- mq_res-ext-2-s2.0-79959964001
- Language
- eng
- Reviewed
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