Autologous fascial slings – efficacy and future challenges. An analytic review

Abstract

Stress urinary incontinence (SUI) consists a clinical entity affecting approximately 1/3 of women worldwide. Therefore, management and therapeutic mapping should be planned assiduously. Surgical treatment for SUI has been an optimal surgical intervention for over 50 years, beginning from Burch colposuspension and Kelly’s plication, to midurethral slings, tension free vaginal tapes, trans obturator tapes and autologous fascial slings. Even though synthetic midurethral slings represented the most common surgical approach since the mid 90’s, due to their minimally invasive character, nowadays, lots of concerns have been raised among medical community concerning their serious long-term complications such as, mesh erosion, vaginal extrusion, urethral erosion and injury, groin, thigh or pelvic pain, recurrent infections and dyspareunia. These complications forced FDA (Food and Drug Administration) to issue a warning against their use, leading the implementation concerning autologous facial slings come back in to the surface. Despite the fact that the use of autologous fascial slings depicts a more invasive and challenging approach to treat SUI, there are notably more benefits regarding postoperative outcome, as well as decreased rate of potential complications when compared to TVT (Tension-free Vaginal Tape) and TOT (Trans Obturator Tape). Although, more trials and data must be conducted in order to be considered as main approach. Aim of this analytic review consists efficacy’s depiction of the autologous fascial slings according to recent bibliography and the role they could play in the near future concerning optimal therapeutic strategy of SUI.