Abstract
Objective: To evaluate objective and subjective outcomes of
patients who underwent sacrocolpopexy using autologous rectus fascia to
provide more data regarding non-mesh alternatives in pelvic organ
prolapse surgery.
Design: Cohort study with retrospective and prospective data.
Setting: A single academic medical center.
Population: Women who underwent abdominal sacrocolpopexy using
autologous rectus fascia between January 2010 and December 2019
Methods: Patients were recruited for a follow-up visit
including completing the Pelvic Floor Distress Inventory (PFDI) and
Pelvic Organ Prolapse Quantification (POPQ) exam. Demographic and
clinical characteristics were collected.
Main Outcome Measures: Composite failure, anatomic failure,
symptomatic failure, and retreatment.
Results: During the study period, 132 women underwent
sacrocolpopexy using autologous rectus fascia. Median follow-up time was
2.2 years. Survival analysis showed that composite failure was 0.8% (CI
0.1-5.9%) at 12 months, 3.5% (CI 1.1-10.7%) at 2 years, 13.2% (CI
7.0-24.3%) at 3 years, and 28.3% (CI 17.0-44.8%) at 5 years. Anatomic
failure was 0% at 12 months, 1.4% (CI 0.2-9.2%) at 2 years, 3.1% (CI
0.8-12.0%) at 3 years, and 6.8% (CI 2.0-22.0%) at 5 years.
Symptomatic failure rate was 0% at 12 months, 1.3% (CI 0.2-9.0%) at 2
years, 2.9% (CI 0.7-11.3%) at 3 years, and 13.1% (CI 5.3-30.3%) at 5
years. Retreatment rate was 0.8% (CI 0.1-5.9%) at 12 months and 2
years, 9.4% (CI 4.2-20.3%) at 3 years, and 13.0% (CI 6.0-27.2%) at 5
years.
Conclusions: Autologous rectus fascia sacrocolpopexy may be
considered a safe and effective alternative for patients who desire to
avoid synthetic mesh.
Funding : internal departmental research funding
Tweetable abstract: Sacrocolpopexy using autologous rectus
fascia is a safe and effective alternative to synthetic mesh.
Keywords: autologous fascia, complications, sacrocolpopexy,
surgical outcomes