The Luksenburg System for Mesh-Free Incontinence Treatment and Majora Laxity

Ariel Luksenburg, M.D., a gynecologist from Uruguay, introduced his system for the treatment of severe stress incontinence to the U.S. in 2021 at the International Society for Cosmetogynecology Pre-Congress workshop in Fort Lauderdale, FL. The course was repeated in 2022 and most recently in March of 2023. This time with FDA clearance to use his threads and patented delivery system. After hearing the system patent was granted, the PCL threads becoming CE and FDA compliant, and seeing the 3-year data presented, I became a believer. I was honored when Ariel Luksenburg and Jorge Gaviria invited me to become the first surgeon in the U.S. to be trained, perform, and to teach The Luksenburg System. They committed to also train my California colleague Judy Wei, MD. We trained on July 24 and 25, 2023, in Irvine, California, at Dr. Judy Wei’s beautiful office and now offer this in Dallas, Las Vegas and Irvine.
Here is a link to my Feminine Wellness Newsletter Video of the procedure:

Ariel Luksenburg, MD, with Red Alinsod, MD

luksenburg non-mesh incontinence treatment

Dr Alinsod was honored to become the first surgeon in the U.S. to be trained, perform, and to teach The Luksenburg System

luksenburg incontinence treatment

Let me summarize the Luksenburg procedure for you.

It is an In-Office, Awake, No-IV, Local Anesthesia procedure using no nylon mesh implants. It uses PCL Threads, a type of absorbable synthetic, that then recreates a new floor under the urethra to replace the saggy one that causes urinary leakage with coughing, sneezing, jumping, running, trampolines, and other sports. If non-surgical treatments such as radiofrequency, lasers, pelvic floor physical therapy, Emsella Chair, or O-Shots don’t work and you don’t want a permanent nylon implant then this is the procedure for you to consider. The success rates are equivalent to and perhaps surpassing the Incontinence Slings I wrote about earlier.

The Process

Three types of PCL Threads are used to create a “Spider Web” of new support.  The first two pinks thread packages on the left are called Net Threads that give the majority of the support under the urethra (tube that drains the bladder).  The middle two with blue are the Pluri Threads (also called the Horsetail threads) that give a broader support of the entire urethral floor.  The last ones on the right are yellow and are the corkscrew thread that support the sides of the urethra right behind the pubic bone to give a nice hammock-type support.

luksenburg threads

Net, Pluri, and Corkscrew threads


Net Thread Placement

Pluri Thread Placement

Pluri Thread Placement

The last step is to inject PRP (Platelet Rich Plasma) to help reduce the overactive bladder, urgency, frequency, and to aid in the healing process. I use the GyCo PRP in this procedure because of its magical effects to shrink tissues immediately as well as provide the growth factors for regeneration and cytokines to reduce inflammation.

luksenburg prp

View with Threads in Place

The Threads in place and creating a new floor for the urethra to rest on and be compressed into from pressure from above to stop leakage.


The arrow in Blue shows the pressure from a cough, a sneeze, a jump as it will then press on the tube (urethra) and close it to stop leaks now that the new floor is created.

Added benefit upon request – GyCo PRP

Upon request, I also place corkscrew threads on the numb labia majora and inject this GyCo PRP that has a tightening effect to give a beautiful external vulvar appearance. The threads result in an internal tightening and lifting effect (just like it does for faces and necks) as it enhances the production of new collagen and elastin. The threads and PRP together also result in a fuller look as it helps volumize and restore fat under the saggy labia majora. This is a jet fueled version of a Vampire Wing Lift. Beauty and Function go well together.

gyco prp