If it weren for the morbidity of harvest, would an autologous graft be an ideal material?
There is no question that the most biocompatible material is the patient’s own fascia. However, in addition to the morbidity of harvest, the fascia may be scarred or deficient from prior surgery, may not be incorporated adequately during healing, and the interface of the sutures and fascial strip may not hold the graft in place adequately during healing. I believe the incidence of postoperative pain from the harvest and the occurrence of abdominal hernia may also be under-appreciated. I learned how to do a urethrolysis treating obstruction from these cases and have also removed fascial graft slings in the bladder and urethra. Whether they have been inadvertently placed at the time of surgery is possible, but I am sure that tightly placed fascial strips with or without surgical entrance into the urinary tract are capable of erosion. Extrusion of biomaterial probably results in infection, discharge, and eventual degradation of the material, which may be considered an advantage over artif
