Inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair

Abstract

Graft augmentation for repair of recurrent pelvic organ prolapse is commonly used in reconstructive pelvic surgery. The reported complications are mainly late onset. We report a case of early-onset inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair. A 49-year-old presented with a recurrent and symptomatic posterior vaginal wall defect. She underwent an uneventful site-specific repair and bovine graft augmentation. Her early postoperative course was complicated by inflammatory response to the graft presenting as intense pelvic floor spasm and urinary retention. The condition was managed conservatively and resolved subsequently. One year later, the patient continues to be asymptomatic. Transient intense pelvic floor spasm and urinary retention can be the result of inflammatory reaction following graft augmentation with bovine pericardium for posterior vaginal wall defect repair.

Pericardial Processing: Challenges, Outcomes and Future Prospects

“…Pericardial bioprostheses have also been described for the treatment of acquired cardiac pathologies, including postinfarction septal defects , reconstruction of mitral valve annulus (David et al, 1995a(David et al, , 1995b or outflow obstruction (Sommers & David, 1997). Additionally, pericardium has also been used for the construction of bioprostheses in noncardiac treatments such as patches for vaginal (Lazarou et al, 2005) or abdominal wall reparation (Limpert et al, 2009), dural repair (Cantore et al, 1987 or tracheoplasty (Dunham et al, 1994).…”

Relapsing constrictive pericarditis after implantation of an expanded polytetrafluoroethylene surgical membrane

“…The pericardium can be reconstructed using biological (heterologous or autologous) or synthetic material, each having their pros and cons. The bovine pericardial patch as heterologous biological material has been demonstrated to be a strong and versatile surgical material but can elicit a hypersensitivity reaction (7). On the other hand, autologous material such as pleural or pericardial fat flaps is well tolerated and infectionresilient but not strong enough (8) .…”

The biochemistry of wound healing in the pelvic floor: What have we learned?

“…Therefore, soaking the mesh in antibiotic solution and preoperative sterile urine are important. Given proper surgeon experience, operations using biologic grafts can produce excellent results with very low erosion rates [46]. Minimizing incision size, size of graft, and length of surgery are principles we have followed to achieve successful outcomes [16].…”

“…We have looked at bacterial adherence of various graft materials [46]; synthetic materials in general have a lower tendency for bacterial adherence than biologic materials.…”