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International Urogynecology Journal

, Volume 16, Issue 5, pp 375–377 | Cite as

Patient characteristics and management of dermal allograft extrusions

  • Natalie L. DrakeEmail author
  • Alison C. Weidner
  • George D. Webster
  • Cindy L. Amundsen
Original Article

Abstract

The objective of this study was to describe our rate of extrusion of dermal allograft material when used in anterior or posterior colporrhaphy and to review our success in treating extrusions with conservative management. A retrospective review of all subjects who underwent vaginal reconstruction using dermal allograft material from 1 January 2000 to 31 August 2003 was performed. Demographics, medical history, and follow-up were evaluated. For subjects who developed an extrusion, treatment details were recorded. Sixty-nine subjects underwent colporrhaphy using dermal allograft material during the defined time period: 21 anterior, 45 posterior, and 3 both. Five subjects did not appear for follow-up. Seven subjects (10.9%) developed an extrusion: three subjects anteriorly and four subjects posteriorly. There were no differences between subjects with and without extrusions based on recorded risk factors. Median time to the discovery of extrusion was 4 weeks (range: 1–6 weeks). All patients were managed with estrogen vaginal cream. Median documented healing time was 13 weeks (range: 5–40 weeks), and no serious morbidity was encountered. Graft extrusion is an uncommon complication when reinforcing vaginal tissue with dermal allograft material and can be safely and effectively managed with vaginal estrogen and expectant management.

Keywords

Cystocele Graft Postoperative complications Reconstructive pelvic surgery Rectocele Vaginal erosion 

References

  1. 1.
    Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRefGoogle Scholar
  2. 2.
    Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRefGoogle Scholar
  3. 3.
    Barber MD, Kuchibhatla MD, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395PubMedCrossRefGoogle Scholar
  4. 4.
    Kobashi KC, Leach GE, Chon J, Govier FE (2002) Continued multicenter followup of the cadaveric prolapse repair with sling. J Urol 168:2063–2068PubMedCrossRefGoogle Scholar
  5. 5.
    Groutz A, Chaikin DC, Theusen E, Blaivas JG (2001) Use of cadaveric solvent-dehydrated fascia lata for cystocele repair—preliminary results. Urology 58:179–183PubMedCrossRefGoogle Scholar
  6. 6.
    Bradley CS, Morgan MA, Arya LA, Rovner ES (2003) Vaginal erosion after pubovaginal sling procedures using dermal allografts. J Urol 169:286–287PubMedCrossRefGoogle Scholar
  7. 7.
    Myers DL, Arya LA (2001) AlloDerm graft for cystocele repair. In: Proceedings of the 21st Annual Scientific Meeting of the American Urogynecologic Society 2000. Int Urogynecol J Pelvic Floor Dysfunct 12 [Suppl]:S60Google Scholar
  8. 8.
    Julian TM (1996) The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475PubMedCrossRefGoogle Scholar
  9. 9.
    Flood CG, Drutz HP, Waja L (1998) Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J 9:200–204CrossRefGoogle Scholar

Copyright information

© International Urogynecology Journal 2005

Authors and Affiliations

  • Natalie L. Drake
    • 1
    Email author
  • Alison C. Weidner
    • 1
  • George D. Webster
    • 2
  • Cindy L. Amundsen
    • 1
    • 2
  1. 1.Department of Obstetrics and Gynecology, Division of Gynecologic SpecialtiesDuke UniversityDurhamUSA
  2. 2.Division of Urology, Department of SurgeryDuke University Medical CenterDurhamUSA

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