Buckley Victoria Anne, Vereeck Sascha, Karjalainen Päivi K, Rosamilia Anna
Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Department of Obstetrics and Gynaecology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Int Urogynecol J. 2025 Nov 11. doi: 10.1007/s00192-025-06421-6.
Fascia lata (FL) is an alternative to mesh for pubovaginal sling (PVS) or abdominal sacrocolpopexy/hysteropexy (ASC). Literature on perioperative complications is sparse. We aim to evaluate the morbidity associated with the FL harvest for treatment of female pelvic floor dysfunction.
Women undergoing FL harvest Feb 2021-May 2025 at a surgeon's private practice and tertiary public hospital. The same harvest technique was used, with graft size depending on the indication (mean size ASC; 13 × 4 cm; PVS 10 × 2 cm). Thigh issues were ascertained by direct questioning and serial follow-up.
Two hundred and one women had FL harvesting, with median follow-up of 12 months (range 3-67). Median age 66 years (range 35-81) and mean BMI 27.7 kg/m (SD 4.4). There were no intra-operative complications of the harvesting. Immediate postoperative complications included one thigh haematoma (ASC) requiring blood transfusion and drainage. At 6 weeks, 64 women (32%) reported 'any' thigh issue, with pain/discomfort the most common (n = 33, 17%). Intervention was rare; two with seroma had aspiration attempted but nothing drained, and five required occasional simple analgesia. At median follow-up of 12 months (range 3-67), 28 (17%) reported 'any' thigh issue on direct questioning. The majority were cosmetic (n = 14, 8%) followed by non-bothersome paresthesia (n = 7, 4%) and discomfort (n = 9, 5%). Two underwent hernia repair with a biological graft. Prospective follow-up of ASC harvest saw thigh issues decline over time. Cosmetic defect was the most common remaining complaint on questioning at 12 months (n = 18, 24%).
Most concerns were minor and required no intervention. No functional deficits were reported and complaints decreased over time.
阔筋膜（FL）可替代网片用于耻骨后阴道悬吊术（PVS）或腹骶骨阴道固定术/子宫固定术（ASC）。关于围手术期并发症的文献较少。我们旨在评估因获取阔筋膜治疗女性盆底功能障碍而导致的发病率。
2021年2月至2025年5月期间，在外科医生的私人诊所和三级公立医院接受阔筋膜获取手术的女性。采用相同的获取技术，移植物大小根据适应证而定（平均大小ASC；13×4厘米；PVS 10×2厘米）。通过直接询问和连续随访确定大腿相关问题。
201名女性接受了阔筋膜获取手术，中位随访时间为12个月（范围3 - 67个月）。中位年龄66岁（范围35 - 81岁），平均体重指数为27.7kg/m²（标准差4.4）。获取阔筋膜过程中无术中并发症。术后即刻并发症包括1例大腿血肿（ASC），需要输血和引流。在6周时，64名女性（32%）报告有“任何”大腿问题，其中疼痛/不适最为常见（n = 33，17%）。干预措施很少见；2例血清肿尝试抽吸但未抽出任何液体，5例需要偶尔使用简单镇痛药。在中位随访12个月（范围3 - 67个月）时，28名（17%）女性在直接询问时报告有“任何”大腿问题。大多数是美容方面的问题（n = 14，8%），其次是不烦人的感觉异常（n = 7，4%）和不适（n = 9，5%）。2例接受了生物移植物疝修补术。对ASC获取手术的前瞻性随访显示，大腿问题随时间减少。在12个月询问时，美容缺陷是最常见的剩余抱怨（n = 18，24%）。
大多数问题较轻，无需干预。未报告功能缺陷，且随着时间推移抱怨减少。
