Anatomical outcome and quality of life following posterior vaginal wall prolapse repair using collagen xenograft |
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Authors: | Daniel Altman Annika López Catharina Gustafsson Christian Falconer Johan Nordenstam Jan Zetterström |
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Institution: | (1) Division of Obstetrics and Gynecology, Pelvic Floor Center, Danderyd Hospital, 18288 Stockholm, Sweden;(2) Division of Surgery, Karolinska Institutet, Danderyd Hospital, 18288 Stockholm, Sweden |
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Abstract: | The aim of this study was to evaluate quality of life, sexual function, and anatomical outcome after posterior vaginal wall prolapse repair using a collagen xenograft. Thirty-three patients were evaluated preoperatively and at 6 and 12 months follow-up (FU). Quality of life and sexual function were assessed using a self-reported questionnaire. Prolapse staging was performed using the pelvic organ prolapse quantification system (POPQ). Preoperatively 3 patients had stage I, 26 patients stage II, and 4 patients stage III prolapse of the posterior vaginal wall. Prolapse of the posterior vaginal wall stage II was observed in 7 patients (21%) at the 6-month FU and in 13 patients (39%) at the 12-month FU. Mean point Bp was reduced from –1.1 preoperatively to –2.5 at 6 months FU (p<0.01) and –1.8 at 12 months FU (p<0.01). Previous abdominal surgery was associated with a less favorable anatomical outcome (odds ratio: 2.0, 95% confidence interval: 1.5–3.8). There were no significant changes in sexual function or dyspareunia during the 1-year FU. Preoperatively 76% of the patients reported a negative impact on quality of life as a result of genital prolapse. There was a significant improvement in several variables associated with quality of life at 6 and 12 months FU. Posterior vaginal wall prolapse repair using a collagen xenograft was associated with an unsatisfying anatomical outcome at 1-year FU although several quality of life-associated variables affecting psychosocial function were improved. Improvement was not restricted to postoperative restoration of vaginal topography, and previous surgery had a negative effect on anatomical outcome. |
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Keywords: | Anatomical Collagen Mesh Prolapse Quality of life Surgery |
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