Research Article
Volume 11 Issue 7 - 2022
Short-Term Safety and Efficacy of Transvaginal Prolapse and Incontinence Repairs with a Novel Acellular Dermal Allograft Using Graft-Only Tissue Technique
Nathan Guerette* and Reilly J
The Intimate Wellness Institute, USA
*Corresponding Author: Nathan L Guerette, MD, CEO, The Intimate Wellness Institute of Virginia, USA.
Received: June 03, 2022; Published: June 28, 2022


Introduction: In the wake of the removal of transvaginal mesh a durable and functionally successful transvaginal method for pelvic organ prolapse repair is needed. This study evaluates a new technique using a novel acellular dermal graft without the need to plicate tissue.

Objective: Determine safety and efficacy of transvaginal pelvic organ prolapse and stress incontinence repair employing a novel acellular dermal allograft.

Materials and Methods: This was a non-probability consecutive retrospective review of patients receiving anterior-apical and/or posterior-apical repair, uterine suspension, and sling with novel allograft graft (AllomendTM, Allosource, Denver, CO, USA) from October 2021 and March 2022. The patients were followed to 3-months post-operative. Surgical technique for apical, uterine, anterior, posterior repair involved proprietary graft design and implantation technique without native tissue repair using modified sacrospinous fixation. Demographics, intraoperative complications, adverse events (AE's) recorded, as was urinary, bowel and sexual symptoms were measured by subjective report and QOL measures (FSFI, UDI-6, IIQ-7). Anatomic efficacy was determined by Pelvic Organ Prolapse Quantification System (POP-Q).

Results: 54 patients were implanted. Mean age 55.6 and median parity 2.0. Procedures performed; vault suspension (43), uterine suspension (29), anterior repair (41), posterior repair (31), sling (20). No intraoperative complications reported. Follow-up obtained at 2-weeks (n = 54), 6-weeks (n = 43), 3-months (n = 28). AE's included 7 patients with UTIs at 2 and 6 weeks, 1 with dysuria at 2-weeks and 3 with fecal incontinence or urgency at 2 and 6-weeks. Baseline prolapse anatomy for areas repaired included median POP-Q values of stage (3), C (-4), D (-5), Aa (0), Ba (0), Ap (0), Bp (0). Median values at both 6-weeks and 3-months were stage (0), C (-10), D (-11), Aa (-3), Ba (-3), Ap (-3), Bp (-3) [all p < 0.001]. At baseline, urge incontinence symptoms present in 49 (91%), stress 51 (94%), mixed 48 (89%). At 3-months there were 2 cases of persistent urge (7%), no persistent stress or mixed symptoms (p < 0.001). Baseline 28 (52%) of patients were sexually active 20 (71%) reporting dyspareunia. At 3-months 18 (64%) of patients were sexually active with no dyspareunia reported (p < 0.001). Mean UDI-6 values at baseline (n = 54) were 59.46 (± 14.34), 1.72 (± 3.45) at 6-weeks (n = 43, p < 0.001) and 2.32 (± 3.62) at 3-months (n = 28, p < 0.001). Mean IIQ-7 values at baseline (n = 54) were 82.07 (± 15.79), 4.63 (± 10.14) at 6-weeks (n = 43, p < 0.001) and 3.96 (± 8.41) at 3-months (n = 28, p < 0.001). Mean FSFI values at baseline (n = 54) were 26.36 (± 6.98) and 31.31 (± 2.57) at 3-months (n = 28, p < 0.001). No anatomic failures, graft exposures or healing abnormalities reported.

Conclusion: Transvaginal prolapse and incontinence repair found to be safe and effective in the short-term utilizing novel acellular graft with technique not requiring native tissue repair.

Keywords: Transvaginal Prolapse; Incontinence Repairs; Novel Acellular Dermal Allograft; Graft-Only Tissue Technique


  1. Sandvik H. “Female Urinary Incontinence Studies Epidemiology and Management in General Practice” (1995).
  2. NIH England. Excellence in Continence Care: Practical guidance for commissioners, and leaders in health and social care (2018).
  3. Jones KA., et al. “Trends in inpatient prolapse procedures in the United States, 1979-2006”. American Journal of Obstetrics and Gynecology 202 (2010): 501.e1.
  4. Choosing the Route of Hysterectomy for Benign Disease. ACOG Committee Opinion 701 (2017).
  5. Weber AM., et al. “Anterior Colporrhaphy: A randomized trial of three surgical techniques”. American Journal of Obstetrics and Gynecology6 (2001): 1299-1306.
  6. Abramovb Yoram MD., et al. “Site-Specific Rectocele Repair Compared with Standard Posterior Colporrhaphy”. Obstetrics and Gynecology2 (2005): 314-318.
  7. S Food and Drug Administration Statement. Urogynecologic Surgical Mesh Implants (2019).
  8. Stilwell R and Delaney R. “The biomechanics of AlloMend acellular dermal matrix: biocompatibility study”. Allo Source White Paper (2016).
  9. Delaney R and Stilwell R. “The biologic properties of AlloMend acellular dermal matrix: growth factor study”. Allo Source White Paper (2016).
  10. Nathan L Guerette., et al. “Anterior repair with or without collagen matrix reinforcement: a randomized controlled trial”. Obstetrics and Gynecology 1 (2009): 59-65.
  11. Gandhi S., et al. “A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse”. American Journal of Obstetrics and Gynecology5 (2005): 1649-1654.
Citation: Nathan Guerette and Reilly J. “Short-Term Safety and Efficacy of Transvaginal Prolapse and Incontinence Repairs with a Novel Acellular Dermal Allograft Using Graft-Only Tissue Technique”. EC Gynaecology 11.7 (2022): 04-07.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

September Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the September issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before October 14, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.