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.