title: Transabdominal sacrocolpopexy with autologous rectus fascia graft.
abstract: OBJECTIVE
  Extrusion and infection are potential postoperative complications when using synthetic mesh for abdominal sacrocolpopexy. Long-term follow-up in the Colpopexy and Urinary Reduction Efforts (CARE) trial revealed an estimated 9.9 % risk of mesh extrusion. There are 26 reports of spondylodiscitis after sacrocolpopexy with synthetic mesh. These surgical risks may be decreased by using autologous fascia. To date, there have been no reports of extrusion or spondylodiscitis after using autologous fascia for sacrocolpopexy.
  
  
  METHODS
  This video demonstrates transabdominal sacrocolpopexy with an autologous rectus fascia graft. A 76-year-old woman with symptomatic stage 3 prolapse also had a history of diverticulitis and sigmoid abscess requiring sigmoid colectomy with end colostomy and incidental left ureteral transection with subsequent left nephrostomy tube placement. She presented for colostomy reversal, ureteral reimplantation, and prolapse repair. Given the need for concomitant colon and ureteral reconstruction, the risk of infection was potentially higher if synthetic mesh were used. The patient therefore underwent transabdominal sacrocolpopexy with autologous rectus fascia graft.
  
  
  RESULTS
  At 4 months' follow-up the patient reported resolution of her symptoms and on examination she had no pelvic organ prolapse.
  
  
  CONCLUSIONS
  Transabdominal sacrocolpopexy using autologous rectus fascia graft is a feasible option, especially in cases in which infection and synthetic mesh extrusion risks are potentially higher.
authors.affiliation: Department of Urology, Montefiore Medical Center, 1250 Waters Place, 9th Floor, Bronx, NY, 10461, USA. nitya.abraham@gmail.com.|Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. nitya.abraham@gmail.com.
authors.forename: Nitya
authors.initials: N
authors.lastname: Abraham
authors.affiliation: Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.|Montfort Hospital, Ottawa, Ontario, Canada.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Quirouet
authors.affiliation: Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Howard B
authors.initials: HB
authors.lastname: Goldman
mesh_terms: D000005:Abdomen / Q000601:surgery; D000368:Aged; D064592:Autografts; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012007:Rectum / Q000637:transplantation; D012447:Sacrum / Q000601:surgery*; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures / Q000379:methods*
keywords: Abdominal sacrocolpopexy; Autograft; Pelvic prolapse surgery; Rectus fascia