I've heard there is a non-mesh sling procedure for the treatment of female stress urinary incontinence. How does it work?
Answer From Daniel S. Elliott, M.D.
The autologous transobturator urethral sling procedure is a 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 (about 5 centimeters).
To place this type of sling, your surgeon makes a small incision inside your vagina, just under your urethra, and creates a small opening on each side of your labia for a needle to pass through. Your surgeon then places the sling under your urethra and closes 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 urethral sling procedure is needed, but initial study results suggest 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.
Sept. 12, 2017
Daniel S. Elliott, M.D.
See more Expert Answers
- Linder BJ, Elliott DS. Autologous transobturator urethral sling placement for female stress urinary incontinence. The Journal of Urology. 2015;193:991.
- Linder BJ, Elliott DS. Autologous transobturator urethral sling placement for female stress urinary incontinence: Short-term outcomes. Urology. 2016;93:55.
- Abbott S, et al. Evaluation and management of complications from synthetic mesh after pelvic reconstructive surgery: A multicenter study. American Journal of Obstetrics and Gynecology. 2014;210:163.e1.
- Jelovsek JE, et al. Surgical management of stress urinary incontinence in women: Choosing a primary surgical procedure. https://www.uptodate.com/contents/search. Accessed Aug. 8, 2017.