A Randomised controlled trial comparing autologus fascia lata and synthetic mesh for abdominal sacrocolpopexy

Abstract

Blood loss, duration of surgery and hospital stay did not differ significantly in the two groups. Anatomical success: Amongst the successfully repaired patients using autologous fascia lata, objective anatomical success rates were superior with reference to POP Q points Aa, Ba, Ap, Bp compared to synthetic mesh. However the anatomical outcome of C point in fascia lata group was comparable to that of mesh group. Functional success: In the current study post operative resolution of lower urinary tract symptoms was equal in both fascia lata and synthetic mesh group. newlineUrinary symptoms: None in the fascia lata group developed UTI however 3.6% in synthetic mesh group developed urinary tract infection in the postoperative follow up. Combining Burch colposuspension along with ASCP for patients who had coexisting SUI (overt and occult) and vault prolapse has cured SUI in both groups. The number of participants who developed denovo SUI was 10.7% in fascia lata group and 3.3% in mesh group. None developed denovo urgency and urge urinary incontinence were same in both groups. Bowel symptoms: Complete resolution of all pre operative bowel symptoms occurred in the autologous fascia lata group incontrast to the mesh group where 3% reported faecal urgency in the postoperative follow up. Sexual symptom: With fascia lata suspension, none developed de novo dyspareunia unlike with mesh suspension. Nevertheless in the synthetic mesh group none developed mesh exposure / extrusion or infection post operatively. In the fasci lata group, there was no significant postoperative morbidity like haematoma, wound infection and muscle herniation from the harvested site. The current study has revealed that vault prolapse repair by abdominal sacrocolpopexy using autologous fascia lata has comparable anatomical success to synthetic mesh. The functional outcome (clinical success) was better with autologous fascia lata suspension compared to meshsuspension.