✦ Stress Urinary Incontinence Treatment

Pubovaginal Sling (Autologous Fascia)

Q: Will the donor site cause problems after fascia harvest?

Minor abdominal wall weakness may occur; most patients have no functional issues from the fascial harvest site long-term. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: How long is recovery from pubovaginal sling?

Hospital stay is 2–4 days; catheter removed at 2–5 days; full recovery takes 6–8 weeks due to the abdominal fascial harvest.

Q: Why choose autologous fascia over synthetic mesh?

Autologous fascia eliminates mesh-related complications; it is preferred for failed previous mesh, intrinsic sphincter deficiency, and mesh-avoidance preference. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Autologous Fascial Sling for Mesh-Free Stress Incontinence Treatment

90–150 min PROCEDURE

2–4 Days HOSPITAL STAY

>80% SUCCESS RATE

6–8 Weeks RECOVERY

What is Pubovaginal Sling (Autologous Fascia)?

The Pubovaginal Sling uses a strip of the patient's own fascia — typically rectus abdominis fascia or fascia lata — as a sling placed under the bladder neck to provide urethral support. It is the preferred mesh-free surgical option for stress urinary incontinence in women who cannot have or do not want synthetic mesh. It is also indicated for intrinsic sphincter deficiency and cases where previous mesh procedures have failed. The procedure is performed under general or spinal anaesthesia with a hospital stay of 2–4 Days.

Women with stress urinary incontinence requiring mesh-free surgery, intrinsic sphincter deficiency, failed previous mid-urethral sling, or recurrent incontinence after prior surgery. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Fascial Strip Harvest

A 2 × 10 cm strip of anterior rectus sheath fascia is harvested through a suprapubic incision.

Retropubic Space Development

The retropubic space of Retzius is entered, exposing the bladder neck and urethra.

Vaginal Wall Incision

A 3–4 cm anterior vaginal wall incision is made at the bladder neck level.

Sling Passage & Bladder Neck Positioning

The fascial strip is passed beneath the bladder neck via the paraurethral tunnels.

Tension Setting & Closure

With the bladder filled to 200 mL, the sling arms are brought together over the anterior rectus sheath and tied at appropriate tension.

Outcomes

90–150 minDURATION

2–4 DaysHOSPITAL STAY

>80%SUCCESS RATE

6–8 WeeksFULL RECOVERY

Who Needs This Treatment?

→Women with severe stress urinary incontinence and intrinsic sphincter deficiency.
→Patients who specifically want to avoid synthetic mesh — including those with prior mesh complications.
→Those with recurrent incontinence after failed TVT, TOT, or Burch colposuspension.
→Women with neurogenic bladder neck incompetence from spinal cord injury.
→Patients undergoing simultaneous anti-incontinence surgery and pelvic organ prolapse repair.
→Those who fully understand and accept the slightly longer recovery from the fascial harvest.

"The autologous pubovaginal sling is our go-to solution when mesh is not an option. Using the patient's own fascia, we achieve excellent continence without the risks associated with synthetic materials."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Will the donor site cause problems after fascia harvest?+

How long is recovery from pubovaginal sling?+

Why choose autologous fascia over synthetic mesh?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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