Self-Fixing Anchoring Mechanism for a Minimally-Invasive Non-Mesh Incontinence Sling

Mesh mid-urethral incontinence slings are unavailable in many nations, and reducing in popularity elsewhere. Harm from surgical mesh is a significant concern, and older procedures such as colposuspension and fascial slings are being reinstituted as replacements. We assessed the feasibility of a minimally invasive technique resembling the mid-urethral sling using absorbable barbed suture to simplify the placement and tensioning of a fascial sling. Five participants were treated with a fascia lata sling using a barbed suture for tensioning. All participants reported a reduction in urinary leakage related to physical activity (UDI-6 score median pre-op 3-“greatly bothered” and median 0 post-op-“not at all bothered”) and no bother with difficult urination at 6 month follow-up. This method is feasible for fascial sling placement and tensioning.