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Sacrocolpopexy: Alternatives to Mesh Grafts. | LitMetric
Introduction And Hypothesis : The ongoing pelvic mesh controversy, coupled with a regulatory pause in using pelvic mesh in some countries, has created a need for mesh-free alternatives for sacrocolpopexy (SCP). This article provides an overview of mesh-free alternatives for SCP.Methods : MEDLINE and PubMed searches were conducted to identify studies reporting on autologous and non-autologous biologic grafts for SCP. Identified studies were reviewed by two of the authors (CY and MR).Results : Emerging evidence on autologous fascia lata (AFL) and rectus sheath (ARS) for SCP is promising, with low donor site morbidity. Non-autologous biologic grafts for SCP are mostly reported to be inferior to mesh.Conclusions : Emerging evidence suggests that AFL and ARS might be safe and effective alternative options to mesh SCP. The main advantages of AFL for SCP over ARS are laparoscopy or robot-assisted laparoscopy approaches, and that a larger graft can be safely harvested. The benefits of utilising allografts and xenografts are limited by their reduced durability compared with mesh and patient acceptability.
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