(Video Poster 25) Retropubic Mid-Urethral Sling Procedure with a Horizontal Vaginal Incision

Objectives: The objective of this research is to identify a novel technique for performing the retropubic midurethral sling procedure such that mesh erosion risk is reduced.

Methods: The retropubic midurethral sling is traditionally performed with a vertical incision at the midurethra, at the level where the sling would be optimally positioned. In this video, we demonstrate a novel technique of using a horizontal incision proximal to the midurethra, such that the vaginal incision is not located over the sling mesh upon completion of the procedure.

Clinical Relevance: With the traditional vertical vaginal incision for retropubic midurethral sling placement, there is an associated risk of mesh erosion and exposure. By utilizing a horizontal vaginal incision proximal to the midurethra instead of a vertical incision at the midurethra, we anticipate that mesh erosion and exposure rates will be diminished, given that the location of the healing vaginal incision is not over the mesh itself.