Female SUI is a common problem causing significant morbidity in women. Its management is usually surgical with Burch’s colposuspension, tension free vaginal tapes. With controversy about artificial tapes, there is need to use autologous tapes for the management.

A total of 15 women between 25-65 years found to have stress urinary incontinence in history, examination and confirmed on urodynamic studies between February 2018 to November 2019 were included in this prospective study. Ethical approval was taken and patient informed written consent was taken. ICIQ (International Consultation on Incontinence Questionnaire) score was calculated in all cases. A low transverse incision was made in lower abdomen and a 8 X 2 cm rectus fascia graft was taken.  Dissection done in Cave of Retzius on vaginal end, a 2-3cm incision was given on anterior vaginal wall below urethra and vaginal mucosa was dissected off the urethraupto inferior pubic rami.  A long Kelly’s clamp was inserted through the abdominal incision in space of Retzius and brought out at vaginal end in the dissected space from where rectus fascia sling with prolene stitch was pulled up on both sides taking care of bladder and urethra. The prolenesutures of the tape were brought above the rectus sheath and tied together after adjusting rectus fascia sling at mid-urethra. Foley’s catheter was kept for 72 hours. Drain was left for 48 hours. Abdomen closed in layers. Post-op ICIQ score was calculated in all patients. Post-op urodynamic studies was done in all cases at 6 weeks.

The mean age was 44.56±7.80 years. Mean BMI was 25.93±3.41kg/m2 while mean parity was 2.93. SUI was demonstrated on urodynamicsin all 15 cases with pdet at Qmax (Detrusor pressure at peak urine flow) in group I was 24.15± 7.05 cm H2O. All patients had symptomatic relief in SUI. At 6 weeks urodynamics, all patients showed pdet at Qmax to be 29.54 ± 6.03 which was significantly higher than preoperative pDet (p= 0.001). Mean operating time was 55.60± 5.72 minutes. PreopICIQ was 16.27 ± 2.28 while it was zero at 6 months follow-up. Mean duration of catheterisation was 5 days.  Seven patients (46.67 %) had retention needing catheter for 7-14 days. Wound Hematuria was seen in 2 (13.3%) patients, wound infection in 4 (26. 70%) cases, erosion in 2 (13.3%), UTI in 1 (6.7%) cases.  In one patient, tape had to be cut while one patient with associated TAH for large fibroid uterus developed VVF which was repaired 3 months later.

The mean age was 44.56±7.80 years. Mean BMI was 25.93±3.41kg/m2 while mean parity was 2.93. SUI was demonstrated on urodynamicsin all 15 cases with pdet at Qmax (Detrusor pressure at peak urine flow) in group I was 24.15± 7.05 cm H2O. All patients had symptomatic relief in SUI. At 6 weeks urodynamics, all patients showed pdet at Qmax to be 29.54 ± 6.03 which was significantly higher than preoperative pDet (p= 0.001). Mean operating time was 55.60± 5.72 minutes. PreopICIQ was 16.27 ± 2.28 while it was zero at 6 months follow-up. Mean duration of catheterisation was 5 days.  Seven patients (46.67 %) had retention needing catheter for 7-14 days. Wound Hematuria was seen in 2 (13.3%) patients, wound infection in 4 (26. 70%) cases, erosion in 2 (13.3%), UTI in 1 (6.7%) cases.  In one patient, tape had to be cut while one patient with associated TAH for large fibroid uterus developed VVF which was repaired 3 months later.

Autologous Pubovaginal sling can be used as an alternative to synthetic slings for surgical management of female SUI with high efficacy but has some complications.