Autologous Sling for Urinary Incontinence: An Alternative to Vaginal Mesh | Amy’s Story

Ready, set, go! Knees up.
Faster, faster. That’s it.
Now we’re getting there! Amy: I’ve always had
a really active lifestyle. Growing up, I was
a three-sport athlete, and then I went on to college
and I played college basketball. Woman:
Run it back, squat, tap. Perfect. Keep going. Amy: After college,
I took up running and I ran a half marathon. I’m really competitive.
I love the competition. – Perfect, perfect, perfect,
perfect. Go, go, go! Amy: Even when I’m doing yoga
which is supposed to be, you know, your Zen,
turning inwards, I’m always trying to do more than the person next to me
is doing. Woman:
And one. Take a breather. Amy: My name is Amy Wallace,
and I came to Penn Medicine due to severe
urinary incontinence. After my first son was born, I had the normal issue
you hear women talk about, you know, when I coughed
or sneezed or jumped. When I had my second son,
he was 10 pounds 7 ounces, and after I had him, I noticed
a marked difference. Like I couldn’t walk
across the room without having issues
with the urinary incontinence. I couldn’t work out. I couldn’t chase my kids
around the backyard. Even just normal functions,
picking things up off the floor caused me to have issues. They just impeded
my day-to-day living. – When a patient
first comes in to talk about
their incontinence, I usually want to gauge
how much it’s bothering them and how much they’re willing
to do to change the problem. When I met Amy, she was wearing two to three pads for protection from leakage and it was really bothering her, especially during activities like running. What kind of activities
are you doing at this point? Amy: Dr. Smith’s bedside manner
was wonderful. She came in smiling, interested
in my life and my kids and what my post-surgery
goals were. She went through
some testing with me and jokingly she says to me, “Oh, you’re leaking
like a sieve. Surgery is definitely
your option.” Dr. Smith: When Amy
came to see me in the office, we talked about
her surgical options. The most commonly performed
surgeries for incontinence involve the use of mesh. Mesh is a material
that can be used to support the bladder
and urethra to help patients regain
control of their bladder. One alternative to mesh
that I like to offer patients is the use of their own tissue, something called
an autologous sling. The autologous sling
uses a small bikini incision to harvest fascia
which lines all of our muscles to be used as the sling. This sling is then placed
to support the urethra in a very similar fashion
to the way mesh is used, and that helps to prevent urinary leakage. – My husband and I
live a really kind of organic, natural lifestyle, and the thought to me
of having the mesh in there was not something
that I was comfortable with. So the fascia procedure, came with
a slightly longer recovery but, knowing that I only had
my body parts inside of my body was important to me. It was just a one-day
outpatient. Like we went back to New York
that night. Everything at Penn
was streamlined, was efficient from
the surgery day to my postop, the patient email system, everything. That made it
just an easy procedure, even traveling
from two hours away. – Hi, how are you?
– Good. – So good to see you!
Welcome back. Amy: She said,
two weeks and you’ll be like, she said you won’t be
running marathons, but you’ll be back to yourself. And I thought how am I
going to have two incisions that you know, two weeks
and I’ll be good to go, and I was. It was incredible. – By six weeks,
she was completely back to doing all the things
she loves doing. And three months later,
she ran her first 5K. – It was just
an amazing feeling, to feel like
I had the life back, the active life that I wanted
to model for my boys and I wanted to have for myself. Thank you so, so much.
Truly I mean that. Like I feel like…
I’m going to get teary-eyed… like you have given me
back my life and I can’t thank you enough
for that. – You’re welcome. You did everything
you were supposed to do. You were quite a pleasure
to take care of. – Thank you. – It really is a lot of fun to
take care of patients like Amy, to see them get back
to their activities, to hear about them
running races and jumping with their children. This certainly is a great job, one that I enjoy doing
every day. Amy: I can’t say enough how much
it has changed my entire life. This actually let me do all the things
that I want to do. It let me be the person
I want to be. It’s been a gamechanger for me.


  1. Scheduled for the mesh, I'm going to talk to the doc about this procedure. Don't really want plastic inside me.

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