Bone-anchored suburethral sling: surgical technique and outcomes

The gold standard treatment for stress urinary incontinence (SUI) is the autologous rectus fascia pubovaginal sling. Although successful, it is associated with increased morbidity related to the graft harvest. Because of this, less invasive techniques were developed, including the retropubic and trans-obturator midurethral sling and the bone-anchored sling (BAS). Early reported outcome failures and concern for bone-anchored-related complications caused BAS to fall out of favor. However, technique modifications and use of a more durable graft or mesh have proven that the transvaginal placement of BAS is actually safe and effective in treating patients with SUI. Further, recent evidence suggests that the bone-anchored sling may be a reasonable option for treatment of patients with moderate to severe and/or recurrent SUI.