Short-Term Outcomes of Single-Arm Sacrocolpopexy with Autologous Fascia Lata.

Abstract

<h4>Introduction and hypothesis</h4>Sacrocolpopexy (ASC) is the gold standard for apical and multicompartment prolapse. With no approved mesh available in Australia, fascia lata (FL) is being offered as an alternative graft. The aim was to examine the outcomes of FL ASC.<h4>Methods</h4>Prospective cohort study of women with ≥ stage 2 prolapse undergoing FL ASC with at least 6 months follow-up. Primary outcome was defined as Patient Global Impression of Improvement (PGI-I). Secondary outcomes were Australian Pelvic Floor Questionnaire (APFQ), Pelvic Organ Prolapse Quantification (POP-Q) System and safety (Clavien Dindo Classification (CDC)). SPSS v29 was used for statistical analysis. Descriptive statistics, chi-square and paired t-test were used.<h4>Results</h4>From Feb 2022 to Jun 2025, 131 were planned for the procedure, seven were excluded from the overal analysis, leaving 124. Of those remaining, 101 (81.5%) had at least 6 months follow-up with a median follow-up of 12 months (range 6-39 months). Mean age and BMI were 67 years and 27 kg/m², respectively. Mean PGI-I was 1.7; 86 (85.1%) reported PGI-I as "very much better" or "much better". Postoperatively, significant improvement was seen in APFQ scores (p < 0.001 bladder and prolapse; p = 0.003 bowel; p = 0.02 sexual function), and mean POP-Q points Ba, C and Bp (p < 0.001). The majority, 79.2%, had no postoperative complications. CDC grade 3 was reported in 5.0%. Repeat surgery for thigh issues and recurrent prolapse were performed in two (2%) and three (3%) patients, respectively.<h4>Conclusions</h4>Our study suggests that FL may be a promising graft for ASC, with high patient satisfaction scores and low major complication rate.