INTRODUCTION
Pelvic organ prolapse is a common condition. Each year, over 300,000 surgeries are performed in the U.S. for pelvic organ prolapse.1,2 Abdominal sacrocolpopexy is an effective technique with several studies demonstrating long-term effectiveness.3 Sacrocolpopexy is most often performed using a synthetic mesh to suspend the vaginal apex to the anterior longitudinal ligament of the sacrum. However, there is a risk of mesh-related complications associated with this procedure. The Colpopexy and Urinary Reduction Efforts (CARE) trial showed an estimated rate of mesh complications of 10.5%.4
Prior studies using alternatives to mesh for sacrocolpopexy have had mixed results. In a randomized trial that evaluated the use of a porcine dermal xenograft versus synthetic mesh, durability was similar at 1 year.5 The porcine graft is no longer commercially available. In another randomized trial of sacrocolpopexy using cadaveric fascia lata versus synthetic mesh, synthetic mesh resulted in better outcomes at 5 years.6
Given patient and provider concerns surrounding mesh use in pelvic reconstructive surgeries, more data is needed regarding non-mesh alternatives. Abdominal sacrocolpopexy using autologous rectus fascia may provide an effective and safe alternative to sacrocolpopexy using synthetic mesh. Although case series have been published with patients undergoing autologous rectus fascia sacrocolpopexies,7,8 no large cohort studies have been conducted with long-term follow-up. The aim of this study is to evaluate objective and subjective outcomes of patients who underwent sacrocolpopexy using autologous rectus fascia.