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Prog Urol 2022 Jul 16;32(7):500-508. Epub 2022 May 16.

Service d'urologie, CHU de Rennes, Rennes, France.

Introduction: Very popular in many parts of the world, autologous fascial pubovaginal sling (AFPVS) remains marginally used in France. However, it may be of particular interest in patients carrying a high risk of mesh-related or device-related related complications. The aim of the present series was to report the outcomes of AFPVS in this high-risk population. Read More

Eur J Obstet Gynecol Reprod Biol 2022 May 31;272:213-216. Epub 2022 Mar 31.

Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, PR China. Electronic address:

Objective: To determine efficacy and safety of salvage autologous pubovaginal sling (PVS) placement after a two or more failed synthetic midurethral sling.

Methods: Women undergoing autologous PVS placement for two or more failed synthetic MUS between 2008 and 2019 were identified. Those patients were conducted a follow-up examination. Read More

Spinal Cord Ser Cases 2022 02 24;8(1):25. Epub 2022 Feb 24.

Princess Royal Spinal Injuries Unit, Sheffield, UK.

Study Design: Retrospective review.

Objectives: Stress urinary incontinence in the neurogenic population can have a profound effect on quality of life. It can lead to significant skin breakdown and non-healing pressure sores. Read More

Int Neurourol J 2021 Sep 30;25(3):202-209. Epub 2021 Sep 30.

Department of Urology, Pusan Nation University School of Medicine, Busan, Korea.

Female urethral diverticulum (UD) is a rare and benign condition that presents as an epithelium-lined outpouching of the urethra. It has various symptoms, of which incontinence in the form of postmicturition dribble is the most common. The gold standard for the diagnosis of UD is magnetic resonance imaging, and the treatment of choice is transvaginal diverticulectomy. Read More

Eur Urol Focus 2021 Sep 8. Epub 2021 Sep 8.

Department of Urology, University College London and London Spinal Injuries Unit, London, UK.

Context: Controversy still exists regarding the balance of benefits and harms for the different surgical options for neurogenic stress urinary incontinence (N-SUI).

Objective: To identify which surgical option for N-SUI offers the highest cure rate and best safety without compromising urinary tract function and bladder management.

Evidence Acquisition: A systematic review was performed under the auspices of the European Association of Urology Guidelines Office and the European Association of Urology Neuro-Urology Guidelines Panel according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Read More

Can J Urol 2021 08;28(S2):27-32

Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

INTRODUCTION Urinary incontinence (UI) is a common condition in all demographics of women and consists of stress UI (SUI), Urgency UI (UUI), and mixed UI (MUI). Treatment includes lifestyle modifications, medical treatment, and surgery depending on the type of UI and severity of symptoms. This review is an update on the evaluation and management of UI in women. Read More

Res Rep Urol 2021 14;13:591-596. Epub 2021 Aug 14.

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Introduction: Pubovaginal sling is an efficient and safe procedure for stress urinary incontinence without the complications of synthetic sling. Urine retention and de novo urgency are bothersome aftermath of this procedure. We aim to identify potential risk factors for de novo urgency after autologous pubovaginal sling. Read More

BJOG 2022 02 17;129(3):500-508. Epub 2021 Aug 17.

Trinity Health of New England, Hartford, CT, USA.

Objective: To perform a cost-effectiveness analysis for the surgical and non-surgical management of stress urinary incontinence (SUI) with and without the availability of midurethral sling.

Design: Cost-effectiveness analysis.

Setting: USA, 2019. Read More

Int J Clin Pract 2021 Oct 5;75(10):e14527. Epub 2021 Jul 5.

Urology Division, Faculdade de Medicina do ABC do Centro Universitário de Saúde ABC, Sao Paulo, Brazil.

Objective: Report the progress of the treatment of female stress urinary incontinence (SUI) in Brazil through vaginal and abdominal approaches and the direct costs by hospitalisation, using DATASUS-a public entity of the Strategic and Participative Management Secretary of Health Ministry, with the responsibility of collecting, processing, and disseminating public health information.

Design: Epidemiological study using the Brazilian Public Health Data Center System (DATASUS).

Participants/materials, Setting, And Methods: Data were collected on all hospital admissions associated with treatment from 2008 to 2019 from the DATASUS. Read More

Clin Obstet Gynecol 2021 06;64(2):297-305

Northwestern University Feinberg School of Medicine, Chicago, Illinois.

The aim was to describe contemporary surgical procedures for the treatment of stress urinary incontinence (SUI) in women. The 4 most commonly performed surgical procedures for the treatment of SUI were reviewed using standardized terminology. We addressed the history and evolution of the procedures as well as the mechanisms of action by which they work. Read More

Urology 2021 08 11;154:103-108. Epub 2021 Apr 11.

Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110. Electronic address:

Objective: To review the rates of persistent and de novo stress urinary incontinence (SUI) following urethral diverticulum (UD) repairs performed without concomitant SUI surgical procedures.

Methods: Following IRB approval, charts of women who underwent UD excision by three FPMRS surgeons were reviewed. Data collected from the electronic medical record included demographic information, preoperative symptoms and evaluation (validated questionnaires [UDI-6, QoL]), imaging studies, operative details, post-operative symptoms, and subsequent surgical interventions. Read More

Int Neurourol J 2021 Jun 29;25(2):111-118. Epub 2021 Mar 29.

Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea.

Currently, the midurethral sling (MUS) is widely used as a standard treatment in patients with stress urinary incontinence (SUI). Several studies have reported the failure rate of MUS to be approximately 5%-20%. In general, sling failure can be defined as persistent SUI after surgery or a temporary improvement in incontinence followed by recurrence. Read More

Int Urogynecol J 2022 04 12;33(4):821-828. Epub 2021 Mar 12.

Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA.

Introduction And Hypothesis: The objective was to report on the very long-term outcome of a published series of autologous pubovaginal slings (PVS) in women with stress urinary incontinence (SUI).

Methods: Following institutional review board approval, a cohort of well characterized, non-neurogenic women who underwent an autologous PVS (primary [PVS1] and secondary [PVS2]) for SUI was re-evaluated for their very long-term outcome status. Data collected included demographics, validated questionnaires (Urogenital Distress Inventory - short form [UDI-6], Incontinence Impact Questionnaire - short form 7, quality of life), SUI retreatment/operations, and subjective patient-reported SUI improvement (%) and symptom recurrence. Read More

J Formos Med Assoc 2021 Jul 16;120(7):1464-1477. Epub 2021 Jan 16.

Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan. Electronic address:

Background/purpose: The impact of neurologic disorders on the clinical outcome of suburethral sling procedures has seldom been studied. Our aim is to elucidate factors predicting further anti-incontinence interventions or transvaginal urethrolysis after a re-adjustable pubovaginal sling procedure (PVS), especially in patients with neurologic disorders.

Methods: Medical records of all consecutive women who underwent re-adjustable PVS for stress urinary incontinence (SUI) were reviewed. Read More

Int Neurourol J 2020 Sep 30;24(3):222-230. Epub 2020 Sep 30.

Department of Urology, KonKuk University Medical Center, KonKuk University School of Medicine, Seoul, Korea.

Stress urinary incontinence (SUI) is a highly prevalent health condition that significantly impacts the quality of life. Traditional methods of treatment for SUI, such as pubovaginal sling and Burch colposuspension, have been replaced by the midurethral sling because of its high efficacy, low complication and morbidity rates, and short learning curve. Although multiple behavioral and operative treatments exist, midurethral slings are the gold standard for the treatment of SUI in women. Read More

Curr Opin Obstet Gynecol 2020 12;32(6):449-455

Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA.

Purpose Of Review: After the Food and Drug Administration Public Health Notification in 2011 regarding transvaginal mesh, there has been a decline in the use of mid-urethral slings (MUS). However, they are an effective treatment option for stress urinary incontinence (SUI) with minimal complications. The management of recurrent SUI after sling continues to be debated. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Sep 3;252:349-354. Epub 2020 Jul 3.

Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.

Objective: To compare short term results of autologous rectus fascia pubovaginal sling surgery with synthetic transobturator vaginal tape procedure in treatment of female stress urinary incontinence (SUI) STUDY DESIGN: It was a comparative study on 30 women between 25-65 years of age with urodynamic proven SUI who were randomly allocated to autologous rectus fascia pubovaginal sling surgery (Group I)(15 women) and synthetic transobturator vaginal tape procedure (Group II) (15 women). Preoperative and postoperative ICIQ (International Consultation on Incontinence Questionnaire) score, urodynamic study and serum CRP and IL-6 were done in all cases.

Results: The baseline characteristics in terms of age, body mass index (BMI), parity, mean ICIQ score and mean preoperative CRP and IL-6 levels were similar in two groups. Read More

Neurourol Urodyn 2020 08 8;39(6):1862-1867. Epub 2020 Jun 8.

University of Iowa, Iowa City, Iowa.

Background: Prevailing theories and treatments of female stress urinary incontinence are built on 120 years of evolution in understanding the structure and function of the female bladder neck and urethra and of considering why treatments failed. In our management of patients, it is important to understand and appreciate how our management of female stress urinary incontinence has evolved and which treatments have prevailed as we advance our knowledge for future treatments.

Aims: The purpose of this review is to describe how advances in technology impacted and shaped prevailing theories or understanding of the pathophysiology of stress urinary incontinence and influences our treatment approach. Read More

Am J Obstet Gynecol 2020 08 3;223(2):273.e1-273.e9. Epub 2020 Jun 3.

Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center/Georgetown University, Washington, DC.

Background: Urethral diverticulum is a rare entity and requires a high suspicion for diagnosis based on symptoms and physical exam with confirmation by imaging. A common presenting symptom is stress urinary incontinence (SUI). The recommended treatment is surgical excision with urethral diverticulectomy. Read More

Urology 2020 09 2;143:266. Epub 2020 Jun 2.

Advanced Urology Associates Pte Ltd, Singapore (formerly Department of Urology, Tan Tock Seng Hospital, Singapore).

Objective: Autologous pubovaginal sling is a surgical option for patients with stress urinary incontinence (SUI), either as primary treatment, or in those who have failed synthetic sling placement. It is also favorable for patients at high risk of mesh erosion, for example, in those who are immunocompromised or postradiation. This video reviews the technical considerations in performing an autologous pubovaginal sling fashioned from rectus fascia in an immunocompromised patient with multiple previous abdominal surgeries. Read More

Am J Obstet Gynecol 2020 05 1;222(5):480.e1-480.e7. Epub 2020 Apr 1.

Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, University of Louisville, Louisville, KY.

Background: As a result of the vaginal mesh controversy, surgeons are performing more nonmesh, autologous fascia pubovaginal slings to treat stress urinary incontinence in women. The rectus abdominis fascia is the most commonly harvested site for autologous pubovaginal slings, so it is crucial that surgeons are familiar with the relationship between this graft harvest site and the ilioinguinal and iliohypogastric nerves, which can be injured during this procedure.

Objective: The aims of this study were as follows: (1) to estimate the safest area between the bilateral courses of the ilioinguinal and iliohypogastric nerves in which a rectus abdominis fascia graft could be harvested with minimal risk of injury to these nerves and (2) to determine the location and dimensions of a graft harvest site that maximized graft length while remaining close to the pubic symphysis. Read More

Female Pelvic Med Reconstr Surg 2020 03;26(3):162-172

Introduction And Hypothesis: Standardized terminology for surgical procedures commonly performed to treat stress urinary incontinence in women is needed to facilitate research, clinical care, and teaching in female pelvic medicine and reconstructive surgery.

Methods: This report combines the input of members of the American Urogynecologic Society and the International Urogynecological Association, assisted by external referees. Extensive searches of the literature were performed, including Instructions for Use brochures and original source documents where possible. Read More

Int Urogynecol J 2020 03;31(3):465-478

Introduction And Hypothesis: Standardized terminology for surgical procedures commonly performed to treat stress urinary incontinence in women is needed to facilitate research, clinical care, and teaching in female pelvic medicine and reconstructive surgery.

Methods: This report combines the input of members of the American Urogynecologic Society and the International Urogynecological Association, assisted by external referees. Extensive searches of the literature were performed, including Instructions for Use brochures and original source documents where possible. Read More

Urology 2020 Mar 27;137:190-195. Epub 2019 Dec 27.

Department of Urology, University of Arizona College of Medicine, Tucson, AZ. Electronic address:

Objective: To address renewed interest in nonmesh transvaginal Pelvic Organ Prolapse (POP) repair since the FDA reclassification of transvaginal mesh, our goal was to develop a transvaginal sacrospinous fixation for anterior and apical POP using only autologous fascia lata. We report our experience in 33 patients.

Methods: Autologous Anterior and Apical Pelvic Organ Prolapse (AAA-POP) repair utilizes a 4 × 14 cm piece of fascia lata harvested through a 3-4-inch upper thigh incision. Read More

Turk J Urol 2019 05 21;45(3):230-232. Epub 2018 Dec 21.

Department of Urology, Health Science University Haseki Training and Research Hospital, İstanbul, Turkey.

Objective: The aim of this study is to describe a novel transobturator midurethral sling surgery technique by using rectus abdominis fascia.

Material And Methods: A 54-year-old woman complaining of urinary leakage during effort was diagnosed as pure stress urinary incontinence after detailed questioning, pelvic examination, uroflowmetry and measurement of residual urine volume. She was anxious about complications related to synthetic meshes. Read More

Arch Esp Urol 2019 Nov;72(9):891-903

Médico y cirujano. Universidad del Rosario. Magister en Epidemiología Universidad del Rosario-Universidad CES. Profesor de carrera escuela de Medicina y Ciencias de la Salud. Universidad del Rosario. Bogotá D.C. Colombia.

Objective: Female urinary incontinence has a prevalence of up to 40%. Stress urinary incontinence is the most frequent type, about 50%. When primary management fails, it is unclear what the behavior should be. Read More

Low Urin Tract Symptoms 2020 Jan 13;12(1):2-7. Epub 2019 Aug 13.

Department of Surgery, Concord Repatriation General Hospital, University of Sydney and Macquarie University, Sydney, Australia.

The contemporary management of stress urinary incontinence (SUI) has seen renewed interest in the use of autologous fascia for the formation of a retropubic suburethral sling. Traditionally, it has been used in only the most severe of incontinence cases, such as those women with intrinsic sphincter deficiency, or in patients requiring concomitant reconstructive procedures. In the current climate surrounding transvaginal mesh, many doctors and patients are shying away from the less morbid synthetic midurethral sling. Read More

Res Rep Urol 2019 19;11:179-188. Epub 2019 Jun 19.

Department of Surgery and Epidemiology & Biostatistics, Western University, London, Ontario, Canada.

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) affect many women in their lifetime. In this review, we describe and evaluate the latest treatment options for SUI and POP, including the controversy around transvaginal mesh (TVM) use. Growing evidence supports the utilization of pelvic floor muscle training as first-line treatment for both SUI and POP. Read More

Female Pelvic Med Reconstr Surg 2020 08;26(8):493-497

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Objective: To compare perioperative and functional outcomes of autologous fascia lata versus rectus fascia pubovaginal sling in female patients with stress urinary incontinence (SUI).

Methods: The charts of all patients undergoing pubovaginal sling for SUI from 2012 to 2017 at a single center were retrospectively reviewed. Patients were divided into 2 groups: those with the sling harvested from the fascia lata (FL group) and those with the sling harvested from the rectus fascia (RF group). Read More