Sacrocolpopexy using autologous rectus fascia: Cohort study of long‐term outcomes and complications

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 Ambispective cohort study with retrospective and prospective data. Setting A single academic medical centre. 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‐20) and Pelvic Organ Prolapse Quantification (POP‐Q) examination. 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. The median follow‐up time was 2.2 years. Survival analysis showed that composite failure was 0.8% (95% CI 0.1%–5.9%) at 12 months, 3.5% (95% CI 1.1%–10.7%) at 2 years, 13.2% (95% CI 7.0%–24.3%) at 3 years and 28.3% (95% CI 17.0%–44.8%) at 5 years. The anatomic failure rate was 0% at 12 months, 1.4% (95% CI 0.2%–9.2%) at 2 years, 3.1% (95% CI 0.8%–12.0%) at 3 years and 6.8% (95% CI 2.0%–22.0%) at 5 years. The symptomatic failure rate was 0% at 12 months, 1.3% (95% CI 0.2%–9.0%) at 2 years, 2.9% (95% CI 0.7%–11.3%) at 3 years and 13.1% (95% CI 5.3%–30.3%) at 5 years. The retreatment rate was 0.8% (95% CI 0.1%–5.9%) at 12 months and 2 years, 9.4% (95% CI 4.2%–20.3%) at 3 years and 13.0% (95% CI 6.0%–27.2%) at 5 years. Conclusion Autologous rectus fascia sacrocolpopexy may be considered a safe and effective alternative for patients who wish to avoid synthetic mesh. Tweetable abstract Sacrocolpopexy using autologous rectus fascia is a safe and effective alternative to synthetic mesh.