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Sacrospinous hysteropexy with an autologous rectus fascia sling for treatment of advanced apical pelvic organ prolapse

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Abstract

Introduction and hypothesis

There is a great interest in avoiding mesh usage in vaginal surgeries. We propose using the autologous rectus fascia to repair apical vaginal prolapse in a similar way it has been successfully used in urinary stress incontinence surgery. This study aims to demonstrate the technique of sacrospinous hysteropexy using autologous rectus fascia for apical pelvic organ prolapse (POP) treatment.

Methods

We present a video of a 63-year-old female with stage IV pelvic organ prolapse and urinary obstruction. A rectus fascia sling of approximately 90 × 10 mm was harvested through a Pfannenstiel incision. It was used in vaginal surgery to suspend the cervix and fix the apical POP.

Results

The patient resumed her usual activities after 1 week and waited 2 months to resume physical activities and sexual intercourse. She is satisfied at 6 months follow-up, without complications or prolapse recurrence.

Conclusion

The sacrospinous hysteropexy using autologous rectus fascia is a feasible technique with excellent results and low risk of complication. Further studies are required to compare POP repair using autologous rectus fascia and polypropylene meshes.

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Authors and Affiliations

  1. Division of Female Urology, Department of Surgery, Faculty of Medical Sciences, University of Campinas, UNICAMP, Rua Vital Brasil, 250, Campinas, SP, 13083-590, Brazil

    Lucas Mira Gon, Cássio Luís Zanettini Riccetto, Fábio Coltro Neto, Arnold Peter Paul Achermann, Thairo Alves Pereira & Paulo Cesar Rodrigues Palma

Authors
  1. Lucas Mira Gon
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  2. Cássio Luís Zanettini Riccetto
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  3. Fábio Coltro Neto
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  4. Arnold Peter Paul Achermann
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  5. Thairo Alves Pereira
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  6. Paulo Cesar Rodrigues Palma
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Corresponding author

Correspondence to Lucas Mira Gon.

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Gon, L.M., Riccetto, C.L.Z., Coltro Neto, F. et al. Sacrospinous hysteropexy with an autologous rectus fascia sling for treatment of advanced apical pelvic organ prolapse. Int Urogynecol J 32, 2291–2293 (2021). https://doi.org/10.1007/s00192-021-04747-5

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  • DOI: https://doi.org/10.1007/s00192-021-04747-5

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