Introduction:
Stress urinary incontinence (SUI) is a common condition that has a
significant impact on quality of life. The integral theory showed that
defective mid urethral support and the resultant low urethral pressure
are the main mechanism behind stress urinary
incontinence1. Concerns have been raised about safety
and long-term complications of vaginal mid-urethral mesh tapes. As a
result, there has been a resurgence in native tissue surgical management
of female stress urinary incontinence. Autologous fascial sling (AFS)
was described almost eighty years ago2. Despite its
high success rate, this procedure, however, requires a laparotomy, and
is associated with high rates of voiding dysfunction post
operatively3. More recently the concept of a sling on
a string was introduced using a laparotomy, with blind introduction of
the strings using a special curved needle4. The ends
of the strings are then sutured to the rectus fascia. In this
prospective cohort study, we evaluate the feasibility, safety and one
year outcomes of the novel technique of laparoscopic mid-urethral
autologous rectus fascial sling insertion (LMAFS) for SUI. We also a
provide video demonstration of the technique described in the
manuscript.