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International Urogynecology Journal

, Volume 28, Issue 8, pp 1159–1164 | Cite as

Solvent-dehydrated dermal allograft (AXIS™) augmented cystocele repair: longitudinal results

  • Saad Juma
  • Omer A. Raheem
Original Article
  • 148 Downloads

Abstract

Introduction and hypothesis

Surgical repair options for pelvic organ prolapse (POP) include native tissue, allograft, xenograft, and synthetic grafts. Solvent-dehydrated dermal allograft (SDDG) has an improved safety profile. We evaluated the long-term safety and efficacy of SDDG use for cystocele repair.

Methods

A total of 184 patients completed a minimum follow-up of 12 months. Incontinence Impact Questionnaire (IIQ), Urogenital Distress Inventory (UDI), and Visual Analogue Scale (VAS) were used pre and post operatively. Recurrent cystocele grade ≥ II and/or repeat cystocele repair were considered objective failure.

Results

Preoperatively, 17 patients (10%) had grade IV cystocele, 87 (47%) grade III, 70 (38%) grade II, and 10 (5%) grade I. All patients underwent SDDG cystocele repair with/without vaginal sling and/or POP repair and/or hysterectomy. Mean hospital stay was 0.58 days (range 0–4), mean estimated blood loss (EBL) was 111 mL, and mean length of Foley catheterization was 1.85 days (range 0–28). Postoperatively, 113 patients (64%) had no recurrent cystocele, 34 (19%) had grade I, 19 (11%) grade II, and 10 (6%) grade III cystocele. None had grade IV cystocele. Nineteen patients (10.3%) underwent repeat cystocele repair. Thirty-eight patients (21.6%) had postoperative recurrence (recurrent cystocele grade ≥ II and/or repeat cystocele repair). Dermal allograft related adverse events included 1 (0.5%) allograft vaginal exposure, dyspareunia 1 (0.5%), and transient hydronephrosis in 1 (0.5%). There were no vascular, vesical, visceral or neurological injuries.

Conclusions

These results indicate that SDDG augmented cystocele repair is a safe procedure, with low morbidity, and it’s success is comparable to other techniques.

Keywords

Dermal Allograft Cystocele Repair 

Abbreviations

IIQ

Incontinence Impact Questionnaire

PPD

Pad per day

QoL

Quality-of-life questionnaires

SDDG

Solvent-dehydrated dermal allograft

SUI

Stress incontinence

UDI

Urogenital Distress Inventory

UUI

Urge incontinence

VAS

Visual Analog Scale

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2016

Authors and Affiliations

  1. 1.Incontinence Research InstituteEncinitasUSA
  2. 2.Department of UrologyUniversity of California San Diego Health SystemSan DiegoUSA

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