Autologous rectus fascia pelvic organ prolapse repair: a mesh free solution for POP?
BAUS ePoster online library. Smekal M.
Jun 26, 2018; 211329
Martina Smekal
Martina Smekal
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Introduction: 40% of women suffer pelvic organ prolapse (POP) in a lifetime. The current standard intervention for vault prolapse is a mesh colposacropexy or hysteropexy. However, patients and surgeons are increasingly hesitant of the use of mesh given recent UK and FDA warnings and litigation. A possible alternative is to use autologous tissue vault support as a mesh free solution. We report a series of four patients undergoing autologous POP repair (APOPR) using rectus fascia.

Patients and Methods: 4 patients with a mean age of 53 (38−68) years underwent APOPR between 2014−2016. All had previous urological/gynecological surgery and declined standard mesh repairs. All had pre−op videourodynamics and defecating MRI evaluation. Mean follow−up is 18 (11−28) months. The APOPR was performed using 10−18 cm of rectus sheath with similar technique to that employing mesh to support the anterior−posterior vaginal walls or encircle the cervix and secured to the sacral promontory.

Results: Results are summarized in Figure 1. All patients have durable result at last follow up.

Conclusions: This is the first description in Europe of APOPR. This series demonstrates feasibility of this technique with successful medium−term outcomes. APOPR avoids the 10−15% risks of mesh−related complications. APOPR and has the potential of a cost−effective and safe alternative for women who wish to avoid mesh. Further studies of long−term durability are needed.
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