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Title: Clinicopathological Study of Patients Requiring Reintervention after Sacrocolpopexy with Xenogenic Acellular Collagen Grafts
Other Titles: Trauma/Reconstruction/Diversion
Authors: Deprest, Jan ×
Klosterhalfen, Bernd
Schreurs, Annick
Verguts, Jasper
De Ridder, Dirk
Claerhout, Filip #
Issue Date: Jun-2010
Publisher: Elsevier Science Inc.
Series Title: Journal of Urology vol:183 issue:6 pages:2249-55
Abstract: PURPOSE: We describe the operative and histopathological findings of patients requiring reintervention because of symptomatic vault prolapse or graft related complications following sacrocolpopexy using xenografts.
MATERIALS AND METHODS: A total of 13 patients underwent secondary sacrocolpopexy because of failure (8) or vaginal revision (5) because of a graft related complication after the initial sacrocolpopexy with porcine dermal collagen (9) or small intestinal submucosa (4). Outcome measures were operative findings and histology of specimens obtained at reintervention. Sections were semiquantitatively scored for the presence of infection, foreign body reaction and fibrosis by a pathologist blinded to the outcome and graft type.
RESULTS: Reinterventions for failure and graft related complications were performed a median of 33 and 15 months, respectively, after the initial operation. Pathology of porcine dermal collagen failures (6) revealed local degradation associated with a minimal foreign body reaction. Porcine dermal collagen remnants were surrounded by minimal fibrosis and neovascularization. Small intestinal submucosa implants of failures (2) were entirely replaced by collagen rich and moderately vascularized connective tissue. Pathology of 3 erosions (all 3 porcine dermal collagen) revealed a locally degraded implant that was surrounded by histiocytes and a polymorphonuclear infiltrate. Pathology of 2 early infections, both small intestinal submucosa, revealed a massive polymorphonuclear infiltration with the implant material remodeled and replaced by loose connective tissue.
CONCLUSIONS: In these clinical recurrences porcine dermal collagen implants were usually locally degraded but still recognizable several years after implantation. Small intestinal submucosa implants were fully replaced by connective tissue. Therefore, the cause of recurrence remains unclear. Porcine dermal collagen erosions displayed features of infection and degradation.
URI: 
ISSN: 0022-5347
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Urology Section (-)
Basic Research in Gynaecology Section (-)
× corresponding author
# (joint) last author

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