ABSTRACT
Successful repair of pelvic floor defects remains one of the greatest challenges facing pelvic reconstructive surgeons. The recognized high rate of recurrence following anterior vaginal wall repairs has led pelvic floor surgeons to augment these repairs with various materials. A variety of prostheses have been used: allografts, xenografts, and absorbable and permanent synthetic mesh. Among the most important advances in this field has been the utilization of new lightweight synthetic mesh and biological grafts into the surgical armamentarium. One of the arguments for using a biological graft versus a synthetic mesh is to theoretically minimize the risk of graft exposure, extrusion, infection, or new-onset dyspareunia. A recent american urogynecologic society (AUGS) survey reported that transvaginal mesh use decreased from 90% in augs survey responders to 61% after the fda safety update in 2011 [1]. Biological grafts represent an important option in transvaginal pelvic reconstruction, especially following heightened public and governmental scrutiny of synthetic materials and the subsequent declining utilization of transvaginal permanent mesh.
