Complete Excision of Sacrocolpopexy Mesh With Autologous Fascia Sacrocolpopexy

Oliver, Janine; Chaudhry, Zaid; Medendorp, Andrew R.; Wood, Lauren N.; Baxter, Z. Chad; Kim, Ja-Hong; Raz, Shlomo

doi:10.1016/j.urology.2017.04.040

Cited by 20 publications

(11 citation statements)

References 21 publications

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“…Known complications of sacrocolpopexy include refractory pelvic pain, suppurative intervertebral discs, new SUI, and mesh erosion into the intestines, bladder, vagina, rectum, and other structures [20]. In our series, the incidence The mean § standard deviation (range) or n (%).…”

Section: Discussionmentioning

confidence: 76%

Short-term Outcomes of Non-robotic Single-incision Laparoscopic Sacrocolpopexy: A Surgical Technique

Liu

Kohn

et al. 2020

Journal of Minimally Invasive Gynecology

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Study Objective: Our main purpose was to describe the surgical technique and short-term outcomes of single-incision laparoscopic sacrocolpopexy (S-LSC) for the treatment of pelvic organ prolapse (POP). Design: This study consisted of a retrospective analysis of 49 consecutive cases. Setting: This study was set at the Third Affiliated Hospital of Guangzhou Medical University from October 2016 to November 2017. Patients: The population for this study consisted of women with stage II to IV POP who met eligibility criteria for laparoscopic surgery. Interventions: S-LSC included the use of V-loc barbed suture and retroperitoneal tunneling, in addition to standard singleincision laparoscopic surgery techniques. All 49 cases were successfully completed. All cases included concomitant procedures; 42 (85.7%) had removal of the uterus and adnexa. The main measured outcomes include patient characteristics, perioperative outcomes, and change in pelvic floor support (Pelvic Organ Prolapse Quantification System), and quality of life (Pelvic Floor Impact Questionnaire). Measurements and Main Results: All patients were parous, and 42.9% had a history of previous abdominal surgery. The mean operative duration from skin to skin was 201.20 § 46.53 minutes. The mean estimated blood loss was 27.0 § 16.6 mL. The mean pre-and post-operative Pelvic Organ Prolapse Quantification System scores were 2.2 § 1.1 cm versus À 2.6 § 0.5 cm for the Aa point and 3.2 § 2.8 cm versus À4.6 § 0.8 cm for the C point (p <.05 for both). The mean pre-and post-operative Pelvic Floor Impact Questionnaire scores were 106.4 § 18.9 versus 8.9 § 4.26 (p <.05), suggesting that S-LSC significantly improved physical prolapse and quality of life. Four patients suffered from postoperative complications (3 mesh exposure and 1 lumbosacral pain). Six patients complained of new onset of stress urinary incontinence. Conclusions: Single-incision laparoscopic sacrocolpopexy is a feasible method to manage POP. However, the long-term effects and complications need to be further investigated.

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Section: Discussionmentioning

confidence: 76%

Short-term Outcomes of Non-robotic Single-incision Laparoscopic Sacrocolpopexy: A Surgical Technique

Liu

Kohn

et al. 2020

Journal of Minimally Invasive Gynecology

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“…In only two of these series (Oliver et al . [15] and our own series) were a free RFS graft employed, and only in our series was the technique of Y-shaped sacrocolpopexy and sacrohysteropexy described. In all these series, the outcomes seem equivalent to those of mesh repairs and significantly better than (Pelvicol) xenograft, although the follow-up is relatively short.…”

Section: Discussionmentioning

confidence: 91%

“…At a median follow-up of 9.9 months, no recurrence of apical prolapse had occurred although two patients required surgery for anterior vaginal wall prolapse. [15]…”

Section: Discussionmentioning

confidence: 99%

The autologous rectus fascia sheath sacrocolpopexy and sacrohysteropexy, a mesh free alternative in patients with recurrent uterine and vault prolapse: A contemporary series and literature review

et al. 2019

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Introduction: About 40% of women suffer pelvic organ prolapse (POP) in a lifetime. The current standard intervention for vault prolapse is a mesh sacrocolpopexy or sacrohysteropexy. However, patients and surgeons are increasingly hesitant to use mesh given recent the UK and Food and Drug Administration warnings and litigation. A possible alternative is to use autologous tissue to support the vault, as a mesh-free solution. We report the outcomes from an initial series of autologous rectus fascia sheath (RFS) sacrocolpopexy and sacrohysteropexy in patients with complex pelvic floor dysfunction. Patients and Methods: All patients had previous, multiple urological/gynecological surgery and declined standard mesh repairs. All had preoperative videourodynamics and defecating magnetic resonance imaging evaluation. The autologous POP repair was performed using 10–18 cm of rectus sheath with a similar technique to that employing mesh to support the anterior-posterior vaginal walls or encircle the cervix and secured to the sacral promontory. Results: Seven patients with a mean age of 52 (33–64) years underwent autologous RFS POP repair between 2014 and 2017. Mean follow-up is 16 (range 2–33) months. All patients have durable result at last follow-up. No significant complications are reported. Conclusions: This is the first report of patients with complex pelvic floor dysfunction and apical POP being managed with autologous RFS sacrocolpopexy/sacrohysteropexy, and only the second report of a free graft being utilized with success. Autologous RFS sacrocolpopexy/sacrohysteropexy avoids the 10%–15% risks of mesh-related complications. Further studies of long-term durability are needed.

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“…Oliver et al reported a series of 19 patients with excision of sacrocolpopexy mesh with replacement of a free rectus fascia graft. 14 Seth et al reported a case series of 7 patients who underwent autologous rectus fascia sacrocolpopexy and sacrohysteropexy with free Y grafts. Mean follow-up was 16 months with all patients having durable results at last follow-up.…”

Section: Discussionmentioning

confidence: 99%

Sacrocolpopexy using autologous rectus fascia: cohort study of long-term outcomes and complications

Wang

Reagan

Boyd

2021

Preprint

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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.

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Complete Excision of Sacrocolpopexy Mesh With Autologous Fascia Sacrocolpopexy

Cited by 20 publications

References 21 publications

Short-term Outcomes of Non-robotic Single-incision Laparoscopic Sacrocolpopexy: A Surgical Technique

Short-term Outcomes of Non-robotic Single-incision Laparoscopic Sacrocolpopexy: A Surgical Technique

The autologous rectus fascia sheath sacrocolpopexy and sacrohysteropexy, a mesh free alternative in patients with recurrent uterine and vault prolapse: A contemporary series and literature review

Sacrocolpopexy using autologous rectus fascia: cohort study of long-term outcomes and complications

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