Abdominal Sacrocolpopexy: Anatomic Outcomes and Complications With Pelvicol, Autologous and Synthetic Graft Materials
Bibliographic record
Abstract
In abdominal sacrocolpopexy (ASC), a graft is used to secure the apex of the prolapsed vagina to the anterior longitudinal ligament of the sacrum. This retrospective cohort study enrolled women having ASC (abdominal sacrohysteropexy or abdominal sacral colpoperineopexy) in the years 2001–2005. Synthetic mesh was used in 52% of 259 ASC procedures; porcine dermis (Pelvicol) in 39%; and autologous fascia in 9%. Patients in whom synthetic mesh was used were older than others, more likely to have had hysterectomy, and likelier to be postmenopausal. Concomitant surgery was performed least often in the synthetic mesh group. Postoperative follow-up averaged 1.1 years. The primary outcome was anatomical failure of ASC at the apical compartment. Rates of apical failure were 11% when Pelvicol was used, 7% with autologous fascia, and 1% with synthetic mesh. All 7 reoperations necessitated for apical prolapse were in the Pelvicol group. Intraoperative and immediate postoperative complications were comparably frequent in the 3 treatment groups. Intraoperative problems included cystotomy in 6% of patients, enterotomy in 1.5%, and a single ureteral injury. Erosions occurred in 11% of the Pelvicol group. Similar numbers of reoperations for graft-related complications were required in all groups. The most common such complications were granulation tissue formation and erosion. These results show that ASC is likelier to fail when Pelvicol is used rather than synthetic mesh or autologous fascia. In addition, using Pelvicol did not lessen the risk of graft-related complications in this study population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".