International Journal of Women's Health (Sep 2017)
Abdominal sacrocolpopexy with Pelvicol xenograft and concomitant Burch colposuspension
Abstract
Sameh Hijazi,1,2 Dieter Echtle,3 Omar M Aboumarzouk,4 Elmar Heinrich2,5 1Department of Urology, Klinikum Ibbenbüeren, Ibbenbüeren, 2Department of Urology, University Medical Center, Goettingen, 3Department of Urology, Städtische Kliniken Mönchengladbach, Mönchengladbach, Germany; 4Urology Department, Newport, Wales, UK; 5Department of Urology, Klinikum Wels-Grieskirchen, Standort Wels, Austria Purpose: To evaluate the efficacy of Pelvicol xenograft use during abdominal sacrocolpopexy to repair pelvic organ prolapse (POP).Patients and methods: A total of 27 consecutive women with symptomatic POP were included in this study. A POP-quantification system and International Continence Society classification were used. Functional and anatomical outcomes were assessed. Subjective outcomes and physical activity after surgery were evaluated due to modified quality of life questionnaire.Results: Median follow-up was 21 months (range: 16 to 41 months). Twenty-four (89%) patients were available for anatomical and subjective evaluation. Preoperative POP- quantification classification was: stage I: 11.1%, stage II: 25.9%, stage III: 48.2%, and stage IV: 14.8%. Overall, pad usage significantly decreased (mean 4.8 vs 1 pads, P=0.001). Stress urinary incontinence significantly improved after surgery in nine women (P=0.001). An additional five women were completely continent. No de-novo incontinence developed. Six women with preoperative urinary retention improved in the amount of residual urine postoperative (mean 35 vs 165 mL). Failure rate was 8.3% at 3 and 11 months after surgery, requiring a second reconstruction. There was no graft related complications or graft rejections necessitating removal occurring. Response rate of the questionnaire was 67%. Two women reported no interference in physical activity after 2 postoperative months, five women after 5 months, and five women 1 year later. Pelvic pain (vaginal pain) was partly improved in eight patients, postoperatively, and ten patients had complete resolution of pain after surgery. Conclusion: This study demonstrates that abdominal sacrocolpopexy is an effective surgical treatment in correcting POP. The use of Pelvicol is associated with a high recurrence rate and increased failure rate compared to traditional sacrocolpopexy with mesh. Larger clinical trials to evaluate the functional and anatomical outcomes are needed. Keywords: prolapse, sacrocolpopexy, implant, xenograft, Pelvicol
