Autologous Fascial Slings: a clinical update

Abstract

Introduction

Autologous Facial Slings (AFS) were first described by Aldridge in 1942. They are recommended as a treatment option for Stress urinary Incontinence (SUI) in women by NICE.

 With rising concerns about mesh implants alternatives to Tension-Free Mid Urethral Tapes are gaining popularity.

 In this article we aim to update our readers on recently published studies involving the use of AFS as an alternative to mid-urethral tapes, in the management of SUI in women

Method

A literature search of Cochrane Library, Embase and Pubmed was conducted, using the keywords: Autologous fascial slings, stress urinary incontinence slings, surgery, tension-free vaginal tape and colposuspension

Findings

We identified a number of case series, however only three comparative trials comparing were found evaluating AFS to vs. mid urethral tapes. One trial was found comparing AFS to Burch colposuspension. We plan to discuss these in details highlighting key learning points

Discussion

There is limited literature comparing AFS to mid other surgical procedures for SUI.

Key advantages appear to be offered by AFS, such as better long-term outcomes. The procedure however does have a distinct complication profile, such as a higher risk of voiding dysfunction.

Conclusion

There is a role for AFS in clinical practice, especially in women wishing a non-mesh surgical alternative for SUI. Patients need to be appropriately counselled of the potential benefits and risks to allow informed decision-making.