Robotic sacrocolpopexy is one of the most common surgical treatment for POP, and is most
often performed using synthetic polypropylene mesh. However, due to the recent controversy
surrounding synthetic materials, a new technique using an autologous graft has been
developed.
The aim of the present study was to report the outcomes of fascia lata sacrocolpopexy.

The charts of all consecutive patients who underwent sacrocolpopexy using autologous
fascia lata for POP at a single academic center between 2021 and 2025 were retrospectively reviewed.
This treatment was offered as an alternative to mesh-based sacrocolpopexy especially in patients with chronic pelvic pain or
those with an history of mesh complication.
Fascia lata harvesting was performed initially through an open and subsequently
through a robotic approach.
Concomitant hysterectomy was performed on a case-by-case basis.
In cases involving concomitant removal of previous sacrocolpopexy mesh, the dissection
plane was preserved when correctly identified.
Our two primary independent endpoints were the subjective success rate (defined as PGII score 1 or 2) and the anatomical success rate (defined as C0).

A total of 21 patients were included in the present analysis.
Most patients (76%) had a history of previous POP surgical repair, with up to 4 prior surgeries in 1
case.
For the four most recent patients, the harvesting was performed robotically.
A uterus-sparing technique was performed in 69% of those still having their uterus.

Concomitant complete removal of a previous sacrocolpopexy mesh was performed in 57% of
patients.
The median operative time was 175 minutes, and the median length of hospital stay was 4
days.
Two patients were readmitted for reoperation (9.5%) : 1 for a retrovesical collection associated with pyelonephritis and 1 for infected pelvic hematoma.
At 3-months follow-up, the anatomical success rate was 88.8% ands the subjective success rate was 87.,5%.
At last-follow-up, these rates were 88.8% and 85.7% respectively.
After a median follow-up of 8 months, only one recurrence of cystocele grade 2 was observed and no reoperation for POP recurrence was performed.

Robotic fascia lata acrocolpopexy appear to be a safe and effective alternative for synthetic mesh in specific cases although the short-term morbidity might be higher.