Related Experiment Video
Updated: Mar 24, 2026
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Transabdominal sacrocolpopexy with autologous rectus fascia graft
Nitya Abraham1,2, Adrienne Quirouet3,4, Howard B Goldman3
1Department of Urology, Montefiore Medical Center, 1250 Waters Place, 9th Floor, Bronx, NY, 10461, USA. nitya.abraham@gmail.com.
Introduction And Hypothesis:
Extrusion and infection are potential postoperative complications when using synthetic mesh for abdominal sacrocolpopexy. Long-term follow-up in the Colpopexy and Urinary Reduction Efforts (CARE) trial revealed an estimated 9.9 % risk of mesh extrusion. There are 26 reports of spondylodiscitis after sacrocolpopexy with synthetic mesh. These surgical risks may be decreased by using autologous fascia. To date, there have been no reports of extrusion or spondylodiscitis after using autologous fascia for sacrocolpopexy.
Methods:
This video demonstrates transabdominal sacrocolpopexy with an autologous rectus fascia graft. A 76-year-old woman with symptomatic stage 3 prolapse also had a history of diverticulitis and sigmoid abscess requiring sigmoid colectomy with end colostomy and incidental left ureteral transection with subsequent left nephrostomy tube placement. She presented for colostomy reversal, ureteral reimplantation, and prolapse repair. Given the need for concomitant colon and ureteral reconstruction, the risk of infection was potentially higher if synthetic mesh were used. The patient therefore underwent transabdominal sacrocolpopexy with autologous rectus fascia graft.
Results:
At 4 months' follow-up the patient reported resolution of her symptoms and on examination she had no pelvic organ prolapse.
Conclusion:
Transabdominal sacrocolpopexy using autologous rectus fascia graft is a feasible option, especially in cases in which infection and synthetic mesh extrusion risks are potentially higher.
Insights
Using autologous fascia for abdominal sacrocolpopexy avoids synthetic mesh complications like extrusion and infection. This approach is a feasible alternative, particularly for patients with higher infection risks.
Area of Science:
- Urogynecology
- Surgical Innovation
- Pelvic Reconstructive Surgery
Background:
- Synthetic mesh use in abdominal sacrocolpopexy carries risks of mesh extrusion (9.9%) and spondylodiscitis (26 reported cases).
- Autologous fascia presents a potential alternative to mitigate these synthetic mesh-related complications.
Observation:
- A case study involving a 76-year-old woman with stage 3 pelvic organ prolapse and a history of complex abdominal surgery (sigmoid colectomy, ureteral injury).
- The patient required concomitant procedures, increasing potential infection risk with synthetic materials.
Findings:
- Transabdominal sacrocolpopexy was successfully performed using an autologous rectus fascia graft.
- At 4-month follow-up, the patient reported symptom resolution and showed no signs of pelvic organ prolapse on examination.
Implications:
- Autologous fascia graft is a viable option for abdominal sacrocolpopexy, especially in patients with elevated risks of infection or mesh extrusion.
- This technique may offer a safer alternative, reducing the likelihood of severe postoperative complications associated with synthetic mesh.
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