CLINICAL APPLICATION OF BIOLOGICALPATCH IN FEMALE PELVIC FLOOR REPAIR
X. LIANG, L. ZHANG;
Departmentof Obstetrics and Gynecology, Dept. of Obstetrics and Gynecology,Beijing J, Beijing, China.
Introduction: The majority ofolder women suffer from pelvic floor dysfunction (PFD). Therecurrence rate of traditional tissue repair surgery is high. Thereare many serious complications such as exposure, erosion and pain. Wetried to use the biological patch to pelvic floor surgery to reducerecurrence and reduce postoperative complications.
Objective:To investigate the potential long-term complications of biologicalpatch in female pelvic floor repair.
Methods: Observationgroup of 22 cases. The operation was performed with 6 layers ofhernia patch. First, all operation was performed with traditionalrepair. 17 patients were treated with a complete biological patch. 4patients were treated with vaginal wall before and after the additionof biological patch vaginal tightening surgery. 1 case was repairedwith biological patch after pelvic cavity. Observation: vaginaldischarge, polyps, infection, pain, erosion and exposure.
Results:The mean follow-up duration was 13.4 ± 8.16 months (12-36 months).Patients were assessed at 2months, 6months, 1 year, 2 year, and 3years after surgery using patient-reported outcomes, and patientsatisfaction. 100% (22/22) patients had a large amount of wateryvaginal discharge, 14% (3/22) polyps. No infection, exposure anderosion. 9% (2/22) patients who had a patch placed on the posteriorvaginal wall and underwent high uterosacral ligament suspensionsuffered from waist pain that had spontaneously healed after 2months. 9% (2/22) patients with mild pelvic pain, improved for 6months. One patient with anterior vaginal wall prolapse had performeda repair operation. 95% (21/22) patients felt the surgery met theirexpectations and 91% (20/22) of them would undergo the same surgeryknowing what they presently knew.
Conclusions: Long-termcomplications of pelvic patch repair are tolerable. However, thelong-term efficacy needs to be further confirmed.
References:1. Explanted specimens were associated with an intense inflammatoryreaction consisting of numerous eosinophils, histiocytes, and plasmacells, with accompanying granulation tissue and fibrosis. 2.Histological examination showed group II patches had greater collagendeposition with central calcification and mild inflammation withinthe residual graft, whereas group I patches were much thinner andwere composed of granulation tissue without evidence of residualgraft. 3. Time to closure for ulcers achieving closure was 2 weeksearlier for the SIS group than for SC. Median reduction in ulcer areawas significantly greater for SIS at each weekly visit (all pvalues<0.05). Review of reported adverse events found no safetyconcerns.