Fascial Sling / Autologous Urethral Slings & Bladder Neck Suspension

A fascial sling, also called an autologous urethral sling, is a surgical treatment for women with stress urinary incontinence (SUI), or urine leakage that occurs with coughing, sneezing, laughing, exercise, lifting, or other activities that place pressure on the bladder. Unlike synthetic midurethral slings, an autologous sling uses a strip of the patient’s own tissue, typically taken from the fascia of the abdominal wall, to create a supportive sling beneath the urethra. The sling helps support the urethra and bladder neck, allowing them to remain closed more effectively when abdominal pressure increases. Bladder neck suspension is another surgical approach that supports and stabilizes the bladder neck and urethra to improve continence. These procedures may be considered for women with significant or persistent stress incontinence, including patients who may not be candidates for or who prefer to avoid synthetic sling materials. Your urologist will evaluate your symptoms, prior treatments, anatomy, and overall health when determining which surgical option is appropriate.

Two surgeons in blue scrubs and masks performing an operation under bright lights
Two surgeons in blue scrubs and masks performing an operation under bright lights

Because a fascial sling uses the patient's own tissue, it avoids placement of a synthetic sling and can provide durable support for stress incontinence. The procedure is performed in an operating room under anesthesia and involves harvesting a small strip of fascia, positioning it beneath the urethra, and securing it to provide support. Bladder neck suspension involves repositioning and securing tissues around the bladder neck and urethra to improve their support. Recovery varies depending on the specific procedure and the individual patient, but patients may need to limit strenuous activity and heavy lifting while the tissues heal. Temporary difficulty urinating, urinary urgency, infection, bleeding, or the need for a temporary catheter can occur. While these procedures can provide significant and long-lasting improvement, they are more invasive than office-based treatments and require a longer recovery. A fascial sling or bladder neck suspension may be recommended when stress urinary incontinence is severe, when previous treatments have not provided adequate relief, or when a patient and physician determine that an autologous, non-synthetic surgical approach is the best fit.