Clinical, anatomical and perioperative outcomes of abdominal sacral colpopexy using autologous fascia: A systematic review of the literature

Giuseppe Campagna; Lorenzo Vacca; Giovanni Panico; Daniela Caramazza; Andrea Lombisani; Franca Natale; Giovanni Scambia; Alfredo Ercoli

doi:10.1016/j.jogoh.2023.102635

Clinical, anatomical and perioperative outcomes of abdominal sacral colpopexy using autologous fascia: A systematic review of the literature

J Gynecol Obstet Hum Reprod. 2023 Oct;52(8):102635. doi: 10.1016/j.jogoh.2023.102635. Epub 2023 Jul 25.

Authors

Giuseppe Campagna¹, Lorenzo Vacca², Giovanni Panico³, Daniela Caramazza³, Andrea Lombisani¹, Franca Natale³, Giovanni Scambia⁴, Alfredo Ercoli⁵

Affiliations

¹ Precision Gynaecological Surgery Unit, Dipartimento Centro di Eccellenza Donna e Bambino Nascente, Fatebenefratelli Gemelli Isola Tiberina, Rome, Italy.
² Precision Gynaecological Surgery Unit, Dipartimento Centro di Eccellenza Donna e Bambino Nascente, Fatebenefratelli Gemelli Isola Tiberina, Rome, Italy. Electronic address: lorenzovacca08@gmail.com.
³ Department of Woman and Child's Health and Public Health, Division of Urogynecology and Reconstructive Surgery of Pelvic Floor, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
⁴ Department of Woman and Child's Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
⁵ Department of Obstetrics and Gynaecology, Division of Gynecology Oncology and Gynecological Minimally invasive surgery, Azienda Ospedaliera Universitaria Gaetano Martino, Messina, Italy.

PMID: 37500014
DOI: 10.1016/j.jogoh.2023.102635

Abstract

Objectives: Although sacral colpopexy is considered the gold standard for the treatment of advanced apical prolapse, several warnings and restrictions has been delivered to urogynecological surgeons in order to avoid the implants of prosthetics meshes. The purpose of this systematic review is to investigate the role of sacral colpopexy performed with autologous tissue in literature.

Methods: a systematic review according to PRISMA guidelines was performed in June 2022 through the Medline, Web of Science and Scopus databases. Quality assessment of each article was performed according to Critical Appraisal tool of Oxford center for EBM, LoE according to SORT standards, ROBINS-I tool for methodological assessment in non-randomized trials. From 236 screened records, 7 articles were considered eligible for this systematic review.

Results: Collected data showed objective cure rate ranging from 94.7% to 100% in medium term follow up. Subjective cure rate was specifically investigated in 2 studies with high satisfaction rates. Complication rate ranged from 0 to 36.8%, with 90.1% graded ≤2 according to Clavien-Dindo classification.

Conclusions: sacral colpopexy with autologous fascia shows satisfying outcomes in terms of safety and efficacy and may be taken in account in particular clinical situations.

Keywords: Autologous fascia; Pelvic organ prolapse; Sacral colpopexy; Systematic review; Urogynecology.

Publication types

Systematic Review
Review

MeSH terms

Abdomen
Fascia
Humans
Pelvic Organ Prolapse* / surgery