Stress urinary incontinence is an important clinical problem that affects millions of women worldwide. Urine leakage occurs secondary to the increase in intra-abdominal pressure due to stress along with an anatomical defect. Management of SUI may be conservative or surgical. Despite the choice they have different cure rates and complications. Surgical treatments in general are more expensive than the conservative ones. We present here a new minimally invasive treatment for SUI  placing of polydioxanone threads, with blunt canulas, in order to reinforcing both the urethropelvic and pubourethral ligaments.

this video shows a new minimally ivasive procedure, carried out in the office, under local anesthesia, using collagenic threads for regeneration of demaged urethral supporting ligaments. For safety, a  Foley catheter with a metallic guide inside is used to move the urethral upwards, avoiding urethral and bladder perforations. Besides the tips of the canula are blunt, making the procedure even safer. Once the urethra and bladder neck are moved upwards, the threads are introduced in the previous made punctures, first in a “X” format and next is an “A” shape creating a backboard support to the urethra, similar to a sling.  Othres threads are inserted laterally reinforcing the urethropelvic liagament and finaly, pre and retropubic special threads are placed reinforcing both the pobourethral ligaments. No catheter is lef in place and the pacient is discharde after spontanous voiding.

Results from our mulicentric database disclosed the following results: A total fo 2042 patiesnts treated, with a mean follow up of 3 years, varying from 12 to 62 months, showed 1674 patents dry (82%), 343 improved ( 15,9%) and 48 failures (2,1%). there was no urniary retention or De novo urugency.Only one patient presentes uretral perforatin, and the thread was easely removed by transurethral approach.

Based on our findings we can conclude that this minimally in office procedure is safe and effective.
At the moment a comparative prospective randomized study comparing this procedure with TOT sling is under way, so we can better understand the role of this new procedure in the urogynecological armamentarium.

Stress Urinary Incontinence: Treatment With Platelet-Rich-Plasma Injection and Placement of Polydioxanone Threads—A Pilot Study Ariel Luksenburg, MD https://orcid.org/0000-0003-0057-5472 arieluks98@gmail.com, Juan J. Barcia, MD, […], and Marco A. Pelosi, III, MD+3View all authors and affiliations Volume 39, Issue 1 https://doi.org/10.1177/0748806821998100
Minimally Invasive, Outpatient, Office Procedure for Severe Stress Urinary Incontinence in Women: Luksenburg Systems LSG3 Ariel Luksenburg, MD https://orcid.org/0000-0003-0057-5472 arieluks98@gmail.com, Juan J. Barcia, MD, […], and Marco A. Pelosi, III, MD+4View all authors and affiliations Volume 41, Issue 4 https://doi.org/10.1177/07488068231166912
Multi material thread lifting and platelet rich plasma for urethral support a new minimally invasive procedure for the treatment of stress urinary incontinence: Preliminary report Pelviperineology 2025;44(2):50-53 DOI: 10.34057/PPj.2025.44.02.2024-7-4 Pablo Gonzalez ISAZA 1 Ariel LUKSENBURG 2 Paulo PALMA 3