Shaw JS, Gerjevic KA, Pollack C, Strohbehn K. Minimally Invasive Autologous Fascia Sling at the Midurethra: A Case Series.
J Minim Invasive Gynecol 2022;
29:1165-1169. [PMID:
35809894 DOI:
10.1016/j.jmig.2022.07.001]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/03/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE
The primary objective was to determine the improvement in stress urinary incontinence symptoms using autologous fascia lata sling placed at the midurethra. The secondary objective was to determine the presence of leg pain after harvest of fascia lata graft.
DESIGN
Case series.
SETTING
Rural academic tertiary care center.
PATIENTS
All women who underwent an autologous fascia midurethral sling over a 1-year period between June 2019 and September 2020.
INTERVENTIONS
Autologous fascia lata midurethral sling.
MEASUREMENTS
Incontinence severity index, urodynamic distress inventory-6, and Likert pain scale.
MAIN RESULTS
Nineteen women received an autologous fascial sling at the midurethra using the described technique-16 fascia lata and 3 rectus fasciae. Mean improvement in incontinence severity index score was 6 points. Mean improvement in urodynamic distress inventory-6 and SUI subscale scores was 14 and 53, respectively, surpassing the minimally important difference for each. Median follow-up time was 9 months (range 2-16). Leg pain at the harvest site was bothersome in 1 patient beyond 6 weeks. Median time to passing voiding trial was 4 days (range 1-13 days). Four patients (21%) had postoperative voiding dysfunction, 3 of which resolved after sling loosening at a mean of 60 days after sling placement.
CONCLUSION
Midurethral autologous fascial sling placement significantly improves symptoms of SUI but carries a risk of voiding dysfunction. Harvesting fascia lata using a fascial stripper is associated with minimal postoperative morbidity.
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