The following is the summary of “Total Autologous Fascia Lata Sacrocolpopexy for Treatment of Pelvic Organ Prolapse: Experience in Thirty-Four Patients” published in the December 2022 issue of Urology by Patel, et al.
Creating a method of open/robotic sacrocolpopexy utilizing a patient’s fascia lata autograft. Researchers present data from their first 34 patients. A fascia lata flap measuring 4-5 cm x 15-18 cm is used during surgery, which is performed by a lateral 3-4 inch incision in the upper thigh. When doing a sacrocolpopexy, the graft is often set up in the standard Y configuration with CV-2 Goretex sutures. Thigh harvest symptoms, including visual analog pain (VAP) ratings, POP-Q scores, and general health, were tracked in patients. Researchers characterized treatment failure as symptomatic pelvic organ prolapse (POP) with apical descent.
In a group of 34 patients with a mean age of 62, surgeons used their fascia lata to perform sacrocolpopexy. Follow-up duration averaged 13 months (range 2-42). Researchers performed 21 robotic sacrocolpopexies and 13 open ones. Hysterectomy (n=9), vaginal mesh excision (n=7), bowel resection and rectopexy (n=5), and autologous sling (n=5) were all performed simultaneously (5). All 34 patients experienced complete remission of their POP symptoms. Most problems at harvest sites were easily dealt with, as expected. The average value for each VAP indicator at the harvest location was 0.4. (range 0-3). In 3 cases, patients noticed slight but not unpleasant swelling in the upper part of their thighs. A seroma formed at the harvest site in one patient.
The slight paresthesias felt at the harvest site were recorded by 12 patients, although they were not considered to be a significant problem. Researchers found no evidence of thromboembolic disease. If you want a non-mesh POP repair but don’t want a mesh implant, autologous fascia lata sacrocolpopexy is a great option. Most problems at harvest sites are relatively modest and may be solved by optimistic site management. The success of this procedure over the long term will be determined by continuing to monitor this series.
Source: sciencedirect.com/science/article/abs/pii/S0090429522007804