Pelvic organ prolapse (POP) can cause significant symptoms and affect quality of life (QoL). Approximately 1 in 10 women will require surgical intervention for POP or incontinence over their lifetime and 30 percent of these women will require reoperation for failed procedures. In response to high rates of recurrence, surgeons have historically attempted to improve outcomes with grafts or mesh. However, the recent controversy and complications associated with mesh repair sparks the need for innovation in this field. Our study aims to find a solution to this problem. The aim of this study was to assess the effectiveness of a novel technique for vaginal prolapse repair utilising autologous vaginal mucosal grafts.

This is a single centre, single operator, retrospective study between January 2017 and December 2024. Patients included in the study had symptomatic vaginal prolapse and underwent repair using a novel technique of transvaginal wall repair using autologous vaginal mucosal grafts. The surgical technique uses autologous vaginal mucosa as an interposition graft to strengthen the repair by inducing post-operative fibrosis. Primary outcome measure of success was freedom from repeat procedures for prolapse and secondary measures were complications, functional outcomes and quality of life measures.

97 patients underwent prolapse repair (74 anterior repair only, 2 posterior repair only and 21 both anterior and posterior repair). Mean age at operation was 68. 26.8% of patients had undergone previous prolapse surgeries. Median vaginal parity was 2 (1-3). Median follow-up was 54 months (37.5-74). Freedom from repeat procedures was 93.8%. Patient reported post-operative success was 84%. There was no reported impact on quality of life related to their prolapse after surgery except for moderate use of incontinence pads. Bleeding was a reported complication in 4.1% of procedures. De novo dyspareunia was reported in 4.1% of patients, with no de novo urinary incontinence or pain.

The use of autologous vaginal mucosal grafts for vaginal prolapse repair offers a promising alternative to traditional methods, with low complication rates and lower recurrence rates without risks posed by synthetic mesh repairs.