Autologous tissue sacrocolpopexy for apical pelvic organ prolapse: a scoping review of the extent, nature, and characteristics of the evidence.

Abstract

<h4>Introduction</h4>Mesh sacrocolpopexy is effective but carries mesh-specific risks. Interest in autologous-tissue sacrocolpopexy using autologous grafts has grown, but its effectiveness and perioperative profile are less clear. This scoping review aimed to map the extent, range, and nature of research on autologous-tissue sacrocolpopexy for apical prolapse, identify knowledge gaps, and summarise reported outcomes and complications.<h4>Methods</h4>Two reviewers independently screened and extracted data in duplicate; a third reviewer resolved disagreements. We mapped 11 studies (n = 311 women). Thematic synthesis was performed; no meta-analysis was conducted.<h4>Results</h4>Eleven studies were included (311 women; sample size range 4-132). Designs were one randomised controlled trial and ten single-arm series; follow-up ranged from about 10 to 60 months. Seven studies used fascia lata and four used rectus fascia; procedures were mainly open with five robotic series. The success rate ranged from 75% to 100%. De novo stress urinary incontinence ranged from 8.3% to 32.5% where reported; de novo urgency urinary incontinence ranged from 0% to 35.6%.<h4>Conclusion</h4>The available literature is limited to small, mostly single-arm studies with short- to medium-term follow-up. Key gaps include a lack of direct comparative trials with mesh, long-term durability data, and standardised outcome reporting.