The autologous fascial sling, made from a strip of the patient’s tissue taken from the lower abdomen or thigh, is used to treat stress urinary incontinence (SUI) in women. This non-mesh sling supports the pelvic floor muscles and helps the urethra withstand increased abdominal pressure applied to the bladder.
Symptoms of Stress Urinary Incontinence
Women with SUI may experience urine leakage during activities that increase abdominal pressure, such as coughing, sneezing, standing up, laughing, exercising, bending over, or lifting heavy objects.
Causes of Stress Urinary Incontinence
SUI can occur if the pelvic floor becomes weakened, stretched, or damaged. Contributing factors include chronic coughing, pregnancy, delivery, labor, nerve injuries to the lower back, and pelvic surgery.
Risk Factors for SUI
Risk factors for SUI include:
- Being female
- Being overweight or obese
- Chronic coughing
- Smoking
- Pregnancy, labor, and delivery
- Pelvic or prostate surgery
- Nerve injury to the lower back
Who Needs an Autologous Fascial Sling?
An autologous fascial sling may be suitable for patients who prefer to avoid synthetic materials, cannot use a synthetic midurethral sling, or have not found relief from previous SUI surgery.
Preparing for Surgery
Before surgery, patients will provide a urine sample to check for a urinary tract infection (UTI). Those with a UTI will need antibiotics before and after the procedure. Patients will receive specific pre-surgery instructions, including fasting and avoiding smoking for six hours before the procedure if general anesthesia is required. They may also need to pause certain medications as directed by their physician.
What to Expect During Surgery
When the patient is under general anesthesia, the surgeon will:
1. Insert a catheter to empty the bladder.
2. Make a small horizontal incision in the lower abdomen to remove a strip of fascia from the rectus muscle.
3. Close the fascial incision and make a small cut in the front of the vaginal wall.
4. Position the fascial strip under the urethra near the bladder and attach it above the pubic bone.
5. Secure the sling with sutures.
6. Use a cystoscopy to check for bladder injuries.
The Recovery Process
Patients typically stay in the hospital for two to three days post-surgery, with a longer stay if they have trouble urinating or if the bladder isn’t emptying completely. Full recovery takes about six weeks. Patients may experience pelvic pain or discomfort when urinating. To aid recovery, patients should:
- Drink one to two liters of fluid daily
- Avoid lifting heavy objects
- Refrain from strenuous exercise
- Take showers instead of baths
- Avoid thermal baths and saunas
- Eat plenty of fiber to prevent constipation
- Avoid vaginal penetration
Patients should contact their doctor if they develop a fever, cannot urinate, have wound pain, experience heavy bleeding or pain, or if the wound starts to bleed or leak fluid.
If you suffer from stress urinary incontinence, the UCI Pelvic Health Center offers effective treatment with an autologous fascial sling. Our expert team provides personalized care to help you regain control and improve your quality of life. Contact us today to schedule a consultation and explore your treatment options for lasting relief from SUI.