Do Biomechanical Properties of Anterior Vaginal Wall Prolapse Tissue Predict Outcome of Surgical Repair?

Alienor S. Gilchrist, Amit Gupta, Robert C. Eberhart, Philippe E. Zimmern

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1069-1073
Number of pages5
JournalJournal of Urology
Volume183
Issue number3
DOIs
StatePublished - Mar 1 2010

Keywords

  • biomechanics
  • cystocele
  • elastic modulus
  • operative
  • surgical procedures

ASJC Scopus subject areas

  • Urology

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