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Sacrocolpopexy using autologous rectus fascia: cohort study of long-term outcomes and complications
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  • Rui Wang,
  • Krista Reagan,
  • Sarah Boyd,
  • Paul Tulikangas
Rui Wang
Hartford Hospital

Corresponding Author:[email protected]

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Krista Reagan
MultiCare Health System
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Sarah Boyd
Penn State Health Milton S Hershey Medical Center
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Paul Tulikangas
Hartford Hospital
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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.
16 Aug 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
18 Aug 2021Submission Checks Completed
18 Aug 2021Assigned to Editor
18 Aug 2021Reviewer(s) Assigned
07 Sep 2021Review(s) Completed, Editorial Evaluation Pending
20 Oct 2021Editorial Decision: Revise Minor
09 Nov 20211st Revision Received
09 Nov 2021Submission Checks Completed
09 Nov 2021Assigned to Editor
09 Nov 2021Review(s) Completed, Editorial Evaluation Pending
24 Nov 2021Editorial Decision: Accept
Aug 2022Published in BJOG: An International Journal of Obstetrics & Gynaecology volume 129 issue 9 on pages 1600-1606. 10.1111/1471-0528.17107