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INTERMEDIATE TERM FAILURE OF PUBOVAGINAL SLINGS USING CADAVERIC FASCIA LATA: A CASE SERIES

2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(05)65299-8

1527-3792

Keith J. O’Reilly, Fred E. Govier,

Pelvic and Acetabular Injuries

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Mar 2002INTERMEDIATE TERM FAILURE OF PUBOVAGINAL SLINGS USING CADAVERIC FASCIA LATA: A CASE SERIES KEITH J. O’REILLY and FRED E. GOVIER KEITH J. O’REILLYKEITH J. O’REILLY and FRED E. GOVIERFRED E. GOVIER View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65299-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The pubovaginal sling procedure using autologous fascia has become the gold standard for treating intrinsic sphincter deficiency and stress urinary incontinence in women. A recent modification has been the use of cadaveric fascia as the sling material. We recently reported similar results for cadaveric fascia lata in 121 women and autologous fascia lata in 46 at a mean followup of 12 months. We have now identified 8 patients who experienced intermediate term failure at 4 to 13 months using cadaveric fascia lata. Materials and Methods: We retrospectively reviewed the records of 8 of 121 patients who received a pubovaginal sling using cadaveric fascia lata between February 1997 and June 1999 and had recurrent stress incontinence after 4 to 13 months. We reviewed the type of fascia, surgical technique, preoperative and postoperative urodynamics, surgical history and medical co-morbidities. Results: We identified 8 patients who underwent a pubovaginal sling using cadaveric fascia lata and had recurrent stress urinary incontinence at a mean of 6.5 months (range 4 to 13) after the procedure. Fresh frozen fascia from a local tissue bank was used and the surgical technique was identical in all cases. Postoperatively urodynamics confirmed recurrent intrinsic sphincter deficiency. Previous incontinence surgery had been done in 7 of the 8 patients. Patient co-morbidities included neurological disease, diabetes mellitus, previous pelvic irradiation and previous pelvic surgery. Conclusions: We identified a higher than expected intermediate term failure rate using fresh frozen cadaveric fascia lata. This risk must be weighed against the advantages of decreased operative time and patient morbidity. Longer followup and larger numbers are necessary to determine how much of a problem exists and what patient characteristics are relevant when selecting cadaveric grafts. References 1 : Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence. J Urol1997; 158: 875. Link, Google Scholar 2 : Outcome in 104 pubovaginal slings using freeze-dried allograft fascia from a single tissue bank. Urology, suppl.2000; 56: 2. Google Scholar 3 : Reduction of patient morbidity and cost using frozen cadaveric allograft fascia for the treatment of intrinsic sphincter deficiency. 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Google Scholar 11 : Is fascia lata allograft material trustworthy for pubovaginal sling repair?. Urology2000; 56: 772. Google Scholar 12 : Functional failure of fascia lata allografts. Am J Obstet Gynecol1999; 181: 1339. Google Scholar 13 : Tissue strength analysis of autologous and cadaveric allografts for the pubovaginal sling.. Neurourol Urodyn1999; 18: 497. Google Scholar 14 : Some effects of gamma irradiation on patellar tendon allografts.. Connect Tissue Res1991; 27: 51. Google Scholar 15 : Human lymphocyte reaction to freeze dried allograft and xenograft ligamentous tissue.. Am J Sports Med1989; 17: 595. Google Scholar From the Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, Washington© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byDmochowski R, Blaivas J, Gormley E, Juma S, Karram M, Lightner D, Luber K, Rovner E, Staskin D, Winters J and Appell R (2018) Update of AUA Guideline on the Surgical Management of Female Stress Urinary IncontinenceJournal of Urology, VOL. 183, NO. 5, (1906-1914), Online publication date: 1-May-2010.GOMELSKY A, RUDY D and DMOCHOWSKI R (2018) PORCINE DERMIS INTERPOSITION GRAFT FOR REPAIR OF HIGH GRADE ANTERIOR COMPARTMENT DEFECTS WITH OR WITHOUT CONCOMITANT PELVIC ORGAN PROLAPSE PROCEDURESJournal of Urology, VOL. 171, NO. 4, (1581-1584), Online publication date: 1-Apr-2004.DORA C, DIMARCO D, ZOBITZ M and ELLIOTT D (2018) Time Dependent Variations in Biomechanical Properties of Cadaveric Fascia, Porcine Dermis, Porcine Small Intestine Submucosa, Polypropylene Mesh and Autologous Fascia in the Rabbit Model: Implications for Sling SurgeryJournal of Urology, VOL. 171, NO. 5, (1970-1973), Online publication date: 1-May-2004. Volume 167Issue 3March 2002Page: 1356-1358 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordstransplantsurinary incontinence, stressfascia latabladderMetricsAuthor Information KEITH J. O’REILLY More articles by this author FRED E. GOVIER More articles by this author Expand All Advertisement PDF downloadLoading ...