Cosmetic and functional impact of fascia lata harvest for use in surgery for stress urinary incontinence

Author:

Johnson Colin1ORCID,Vollstedt Annah1,Nakatsuka Hannah2,Orzel Joanna1,Takacs Elizabeth B.1ORCID

Affiliation:

1. Department of Urology University of Iowa Hospitals and Clinics Iowa City Iowa USA

2. Department of Urology University of Iowa Carver College of Medicine Iowa City Iowa USA

Abstract

AbstractIntroductionThere has been increased interest in using autologous tissues since the Food and Drug Administration banned transvaginal mesh for pelvic organ prolapse in 2019. Our study aims to assess patients’ perspective of functional and cosmetic impact on the fascia lata harvest site in patients undergoing fascia lata harvest for the treatment of stress urinary incontinence (SUI).MethodsThis is a prospective survey study of a retrospective cohort of patients who underwent a fascia lata pubovaginal sling between 2017 and 2022. Participants completed a survey regarding the functional and cosmetic outcomes of the harvest site.ResultsSeventy‐two patients met the inclusion criteria. Twenty‐nine patients completed the survey for a completion rate of 40.3%. For functional symptoms, 24.1% (7/29) of patients reported leg discomfort, 10.3% (3/29) reported leg weakness, 10.3% (3/29) reported a bulge, 17.2% (5/29) reported scar pain, 14.8% (4/27) reported scar numbness, and 17.2% (5/29) reported paresthesia at the scar. For cosmetic outcomes, 72.4% (21/29) reported an excellent or good scar appearance. On the PGI‐I, 75.9% (22/29) reported their condition as very much better (48.3%, 14/29) or much better (27.6%, 8/29).ConclusionsThe majority of patients reported being satisfied with the functional and cosmetic outcomes of their harvest site as well as satisfied with the improvement in their SUI. Less than 25% of patients report harvest site symptoms, including leg weakness, scar bulging, scar pain, scar numbness, or paresthesia in the scar. This is important in the context of appropriate preoperative discussion and counseling regarding fascia lata harvest.

Publisher

Wiley

Reference26 articles.

1. FDA Public Health Notification: Serious Complications Associated with Transvaginal Placement of Surgical Mesh in Repair of Pelvic Organ Prolapse and Stress Urinary Incontinence.Public Health Notification. U.S. Food and Drug Administration.2008.

2. Update on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse: FDA Safety Communication. FDA Safety Communication.U.S. Food and Drug Administration 2011.

3. FDA takes action to protect women's health orders manufacturers of surgical mesh intended for transvaginal repair of pelvic organ prolapse to stop selling all devices.U.S. Food and Drug Administration;2019.

4. Resurgence of Autologous Fascial Slings in a Challenging Climate for Sling Surgery: A 20-Year Review of Comparative Data

5. Total Autologous Fascia Lata Sacrocolpopexy for Treatment of Pelvic Organ Prolapse: Experience in Thirty-Four Patients

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