I've heard there is a new non-mesh sling procedure for the treatment of female stress urinary incontinence. How does it work?

Answers from Daniel S. Elliott, M.D.

The autologous transobturator midurethral sling procedure is a new treatment developed at Mayo Clinic for female stress urinary incontinence — the unintentional loss of urine prompted by a physical movement or activity.

A minimally invasive, outpatient procedure, this technique uses a small piece of your own fibrous tissue (fascia) for the sling instead of mesh. The tissue is harvested from your abdominal muscles through a 2-inch abdominal incision. To place this type of sling, your surgeon will make a small incision inside your vagina, just under your urethra, and create a small opening on each side of your labia for the needle to pass through. Your surgeon will then place the sling under your urethra and close the vaginal incision. The sling supports your urethra and helps keep it closed — especially when you cough or sneeze — so that you don't leak urine.

While using surgical mesh may be an effective treatment for stress urinary incontinence, complications can occur in some women, including erosion of the material, infection and pain. Further research on the autologous transobturator midurethral sling procedure is needed, but a 2014 study suggests it's effective in the short term.

If you're considering surgery to treat female stress urinary incontinence, talk to your doctor about the options. He or she can help you weigh the risks and benefits of different surgical treatments.


Daniel S. Elliott, M.D.

Aug. 22, 2014 See more Expert Answers