Yong Chin, Raoofi Mooska, Carey Marcus
Epworth HealthCare, Suite 6.3, Level 6, 124 Grey Street, East Melbourne, Victoria, 3002, Australia.
Int Urogynecol J. 2025 Jan;36(1):3-10. doi: 10.1007/s00192-024-05956-4. Epub 2024 Oct 30.
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.
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).
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.
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.
持续存在的盆腔网片争议，再加上一些国家对盆腔网片使用的监管暂停，使得骶骨阴道固定术（SCP）需要无网片替代方案。本文概述了SCP的无网片替代方案。
进行了MEDLINE和PubMed检索，以识别报告用于SCP的自体和非自体生物移植物的研究。由两位作者（CY和MR）对识别出的研究进行综述。
关于自体阔筋膜（AFL）和腹直肌鞘（ARS）用于SCP的新证据很有前景，供区发病率低。大多数报告称用于SCP的非自体生物移植物不如网片。
新证据表明，AFL和ARS可能是SCP网片的安全有效替代选择。AFL用于SCP相对于ARS的主要优势在于可采用腹腔镜或机器人辅助腹腔镜方法，并且可以安全获取更大的移植物。与网片相比，同种异体移植物和异种移植物的耐用性降低以及患者可接受性限制了其益处。
