Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2026
Human Acellular Dermal Matrix Versus Polypropylene Mesh in Pelvic Floor Reconstruction: A Retrospective Study on Surgical and Sexual Outcomes.
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Sun Yuhan, Qu Qinghua, Jiang Lu, Liu Lubin
Аннотация
OBJECTIVES: To compare surgical outcomes and sexual quality of life following pelvic floor reconstruction using human acellular dermal matrix (ADM) versus polypropylene mesh (PM).
METHODS: This retrospective study included patients with anterior compartment and uterine prolapse who underwent transvaginal anterior sacrospinous ligament fixation between September 2021 and July 2023. Patients were grouped by graft type: ADM (n = 16) or PM (n = 25). Primary outcomes included operative data, complications, Pelvic Organ Prolapse Quantification scores, and quality-of-life questionnaires (Pelvic Floor Distress Inventory-20, Pelvic Floor Impact Questionnaire-7, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12) at 3 and 12 months postoperatively.
RESULTS: Both groups showed significant postoperative improvements in Pelvic Organ Prolapse Quantification parameters and functional scores compared to baseline (P < 0.05). No significant differences were found between groups regarding blood loss, complication rates, or recurrence. The ADM group required significantly longer operative time than the PM group (88.06 vs. 61.68 minutes, P < 0.001). Postoperative dyspareunia was lower in the ADM group (7.7%) compared to the PM group (20%), though this difference was not statistically significant.
CONCLUSIONS: Both ADM and PM provide comparable anatomical success and improved patient well-being in pelvic floor reconstruction. ADM may offer advantages in preserving sexual function by reducing dyspareunia, although larger multicenter studies are needed to confirm these findings.
METHODS: This retrospective study included patients with anterior compartment and uterine prolapse who underwent transvaginal anterior sacrospinous ligament fixation between September 2021 and July 2023. Patients were grouped by graft type: ADM (n = 16) or PM (n = 25). Primary outcomes included operative data, complications, Pelvic Organ Prolapse Quantification scores, and quality-of-life questionnaires (Pelvic Floor Distress Inventory-20, Pelvic Floor Impact Questionnaire-7, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12) at 3 and 12 months postoperatively.
RESULTS: Both groups showed significant postoperative improvements in Pelvic Organ Prolapse Quantification parameters and functional scores compared to baseline (P < 0.05). No significant differences were found between groups regarding blood loss, complication rates, or recurrence. The ADM group required significantly longer operative time than the PM group (88.06 vs. 61.68 minutes, P < 0.001). Postoperative dyspareunia was lower in the ADM group (7.7%) compared to the PM group (20%), though this difference was not statistically significant.
CONCLUSIONS: Both ADM and PM provide comparable anatomical success and improved patient well-being in pelvic floor reconstruction. ADM may offer advantages in preserving sexual function by reducing dyspareunia, although larger multicenter studies are needed to confirm these findings.