Urogynecology and Pelvic Surgery

Autologous Fascial Sling Procedure

What is an autologous fascial sling

An autologous fascial sling is used to correct stress urinary incontinence (SUI). SUI is when you involuntarily leak urine (pee) when sneezing, laughing, coughing or doing exercise. It is a very common condition that occurs in 1 in 3 women.

SUI occurs when the muscles and tissues that support the urethra (the tube that carries urine from your bladder to outside your body) are weakened. The autologous fascial sling uses your own tissue (taken either from the abdomen or the thigh) to create a sling to support the urethra. Unlike midurethral slings, which are placed under the middle part of the urethra, an autologous fascial sling is placed at the neck of the bladder (where the bladder and urethra connect). Although autologous fascial sling can be used to treat SUI, it usually is not the first choice because the procedure is more invasive and takes longer than other options. Conditions where an autologous fascial sling may be a better choice include:

  • Severe stress urinary incontinence
  • Intrinsic sphincter deficiency (when the muscles that close the urethra are weak or damaged)
  • The urethra can’t move
  • When urethral reconstruction is being done at the same time

How is the procedure performed?

Autologous fascial sling procedures are performed in 2 steps:

  • First, fibrous tissue called fascia is taken from around the patient’s abdominal muscles or thigh muscles. The surgeon makes a small cut in the lower abdomen or upper thigh to get the fascia.
  • Second, the surgeon makes a small cut in the front wall of the vagina, near the bladder neck. The strip of fascia is looped under the top of the urethra, and the ends are attached to the tissue surrounding the abdominal muscles with permanent sutures (stitches).
  • After the sling is in place, your doctor will insert a tiny camera called a cystoscope into your bladder to check that it was not injured.

What can I expect from an autologous fascial sling?

You may be asked to undergo some bladder testing called urodynamic testing. You’ll need to attend a preoperative visit where you will talk with your doctor about what to expect and undergo some basic lab work. If you need surgical clearance or prior authorization, you will be asked to get this before surgery.

Autologous fascial sling takes about 1 hour to complete, and you’ll be under general anesthesia. You’ll stay in the hospital overnight.

What will recovery be like?

Most patients report minimal pain with autologous fascial sling, but you can expect some activity restrictions for about 6 weeks. Many patients can return to a normal routine shortly after surgery. Activity restrictions include:

  • No heavy lifting of more than 10 pounds
  • No baths or soaking (showers are OK)
  • No sexual intercourse
  • No driving while on narcotic pain medications

What are the risks of autologous fascial sling?

The risk of complications from autologous fascial sling is typically very low. As with any procedure, there is a risk of anesthesia problems, pain, bleeding, infection, blood clots or damage to nearby organs. Risks specific to this procedure include:

  • urinary tract infection
  • problems emptying the bladder completely
  • bladder injury

Will my insurance company cover the procedure?

Our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier for details of your coverage.