It is reported that the complication rate of female stress urinary incontinence (SUI) patients receiving autologous
fascia sling (AFS) was much lower than the group using prolene mesh, in spite of the longer operation time and hospital stay. Nowadays, under the circumstances of decreasing the usage of prolene mesh sling, sling operation with AFS is becoming popular in incontinence surgery in many western countries.1

The video demonstrates the modified AFS surgery for female patient with stress urinary incontinence, instead of using synthetic mesh. Trans-obturator approach was to avoid bladder injury and bleeding, which occurs in traditional pubovaginal fascia sling. Novelty barbed sutures (V-Loc) was used to lock fascial sling in place, to minimize wound size, and for convenient sling tensioning. There are 14 female SUI patients received trans-obturator procedures with AFS from April 2017 to December 2017 in this series.

The mean age of patients was 60.0 years (42-78). There was no intra-operative complication, such as bladder perforations, found during surgery. Follow-up duration is from 3 to 11 months. During the follow-up duration, no post-operative complications were reported. For the time being, the continence rate and total satisfaction rates are 100%.

This video revealed that the usage of V-Loc sutures in AFS is one feasible and more straightforward method for urinary incontinence.

Linder BJ, Elliott DS. Autologous transobturator urethral sling placement for female stress urinary incontinence. J Urol. 2015 Mar;193(3):991-6.