ISSN 2149-3235 | E-ISSN 2149-3057
Surgical Technique
Autologous transobturator midurethral sling
1 Department of Urology, Health Science University Haseki Training and Research Hospital, İstanbul, Turkey  
Turk J Urol ; : -
DOI: 10.5152/tud.2018.83797
Key Words: Autologous; midurethral sling; stress incontinence.
Abstract

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 diagnosed with pure stress urinary incontinence after detailed questioning, pelvic examination, uroflowmetry and residual urine volume measuring. She was anxious about complications related to synthetic meshes. However, she was not interested in relatively morbid surgeries such as colposuspension and pubovaginal sling. Autologous transobturator midurethral sling was discussed with the patient. The patient approved the surgery and the surgery was planned. A five centimeter rectus fascia was harvested via suprapubic insision and non-absorbable stay sutures were placed on its’ both edges. Anterior vaginal incision and paravaginal dissection was performed, as in classical transobturator sling surgery. Groin puncture and blind fatty tissue dissection was performed. C-shaped trocars inserted into the groin punctures and brought to midurethral incision by finger guidance. Stay sutures were transported via C-shaped trocars to the groin puncture in both sides. Graft was positioned on the midurethral part without any tension and stay sutures were tied to create a tissue bridge on obturator membrane. Incisions were closed and vaginal tampon was placed. Patient was discharged at first post-operative day.

 

Results: At post-operative third and sixth months, patient was totally dry and did not have any voiding complaints. Small abdominal and vaginal incisions were clean, as well.

 

Conclusion: Autologous transobturator midurethral sling surgery is a safe, effective and feasible surgical option for stress urinary incontinence in the era which mesh related concerns are rising. Studies with larger volume and long term follow up are needed.

 

Cite this article as: Çubuk A, Erbin A, Savun M, Ayrancı A, Üçpınar B, Yanaral F, et al. Autologous transobturator midurethral sling. Turk J Urol 2019; DOI: 10.5152/tud.2018.83797

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