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.