Biologic Materials for Pelvic Floor Reconstruction

Abstract

The use of biologic grafts in the surgical treatment of pelvic prolapse repair has been an intriguing prospect for several years. These tissues have been thought to potentially combine favorable attributes of both autologous and synthetic tissues. These tissues are harvested and undergo complex decellularization, dehydration, terminal sterilization, and possibly cross-linking. It is these steps that determine the graft’s eventual biocompatibility and potential for remodeling. A PubMed literature search has revealed a number of studies evaluating cadaveric allografts and bovine and porcine xenografts in repairs of the anterior, posterior, and apical compartments. While the study quality varies significantly, overall, there is little compelling evidence to unequivocally support the use of a biologic tissue in any compartment. Furthermore, an analysis of postoperative complications reveals a similarity in graft-related complication profiles between some biologic grafts and synthetic meshes.