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Do Biomechanical Properties of Anterior Vaginal Wall Prolapse Tissue Predict Outcome of Surgical Repair?
- Source :
- Journal of Urology; Mar2010, Vol. 183 Issue 3, p1069-1073, 5p
- Publication Year :
- 2010
-
Abstract
- Purpose: We determined the relevance of the biomechanical properties of freshly harvested vaginal tissue during large cystocele repair on clinical outcome at a minimum 1-year followup. Materials and Methods: With institutional review board approval we prospectively studied the biomechanical properties of full thickness vaginal wall tissue from postmenopausal women with symptomatic Baden-Walker prolapse undergoing anterior vaginal wall suspension with cystocele repair from 2002 to 2005. A standardized biomechanical protocol was applied with stress-strain curves for Young''s modulus obtained by blinded investigators. Failed repair was defined as recurrence on examination or reoperation for recurrent anterior prolapse. Results: A total of 32 patients (median age 72 years) had a median followup of 34 months (range 12 to 62). Median Young''s modulus was statistically different in tissue samples transported in immersed vs moistened media (median 3.8 vs 7.6, p = 0.008). Associations between Young''s modulus and clinical variables were described. On followup 7 patients experienced failure of the repair. After controlling for tissue transport protocol no association was seen between Young''s modulus and failures (HR 1.1, p = 0.34). Conclusions: This study found no association between Young''s modulus and clinical results at long-term followup. This finding suggests that retropubic scarring and pelvic floor muscle properties may be more important for a successful reparative outcome than the intrinsic properties of the vaginal wall. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 00225347
- Volume :
- 183
- Issue :
- 3
- Database :
- Supplemental Index
- Journal :
- Journal of Urology
- Publication Type :
- Academic Journal
- Accession number :
- 48148907
- Full Text :
- https://doi.org/10.1016/j.juro.2009.11.025