Hypothesis / aims of study
Robotic sacrocolpopexy is one of the most common surgical treatment for POP, and is mostly performed using synthetic bandlets made of polypropylene. However, due to the recent controversy on synthetic materials, a new technique using autologous membrane bandlets has developed. The aim of the present study was to compare the outcomes of autologous vs synthetic bandlets in sacrocolpopexy.
Study design, materials and methods
The charts of all consecutive patients who underwent robotic sacrocolpopexy for POP at a single academic center between 2013 and 2023 were retrospectively reviewed. Procedures including rectopexy were excluded. The autologous membrane bandlets technique was developed in 2022. From this moment, it was mostly used for patients with history of explanted sacrocolpopexy bandlets for complications (pain, bladder extrusion, vaginal exposition) or patients refusing synthetic materials.
Interpretation of results
The mean operative time was not significantly different between the two groups (190 vs 165 min ; p = 0,14). The mean length of hospital stay was significantly longer in the autologous group (4,2 vs 1,8 days ; p = 0,007). The readmission rate was not different between the two groups (18 vs 2% ; p = 0,08) ; moreover, the rate of new surgery for POP relapse was not different between the two groups, but was higher in the synthetic group (0 vs 3,8% ; p = 0,99). At 3 month follow-up, there was no difference between the two groups in term of rate of Baden-Walker grade ≥ 1 cystocele or uterine prolapse (10 vs 7,9% ; P = 0,98) or in term of rate of PGII 1 or 2 (100 vs 91% ; p = 0,99). At last follow-up, those two outcomes were not significantly different either (prolapse : 0 vs 6% ; p = 0,99 - PGII : 100 vs 95% ; p = 0,27). However, the PGII 1 or 2 rate for autologous bandlets was always 100%. The mean follow-up time was similar (6 vs 17 month ; p = 0,64).