Rectus Fascia Pubovaginal Sling

An excellent treatment for female stress incontinence

There are 2 general types of pubovaginal sling: synthetic, and autologous. "Autologous"  just means using your own tissue, and the most used type of autologous sling is rectus fascia. This is the tough lining of your abdominal muscle (rectus).

The process

  • A rectus fascia pubovaginal sling is done via 2 incisions.
  • The first incision in the abdomen is to remove a section of rectus fascia to use as the sling. This is generally 9 by 2 cm, and the incision is similar to what you would have if you were having a cesarean section.
  • Another incision is made in the vagina to place the sling accurately.

What are the benefits of a rectus fascia pubovaginal sling? 

  • The main advantage of a rectus fascia sling is that it is using your own material.

  • Synthetic slings are an excellent treatment in the right woman, but some women would prefer to have their own tissue used as a sling.

  • The downside of a rectus fascia sling is that it is a longer, more involved procedure. The larger incisions mean that you are in the hospital for a longer period of time (2-3 days), you have a longer recovery once you are home, and the bladder takes a longer time to recover afterwards. This means that you are more likely to need to pass a catheter to drain your bladder when compared to a synthetic sling procedure (intermittent self-catheterisation).

For more information, see the stress incontinence decision-making guide.

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