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Autologous fascial sling vs polypropylene tape at short-term followup: a prospective randomized study.
J Urol. 2005 Sep; 174(3):990-3.JU

Abstract

PURPOSE

The incidence of urinary incontinence in women of childbearing age is about 30%. Around half have stress incontinence. Many treatment modalities have been elucidated to treat stress incontinence, and among the most popular are rectus fascia sling and tension-free vaginal tape (TVT). The introduction of TVT to the urological armamentarium put a multiplicity of synthetic materials into use in the correction of stress urinary incontinence. A comparison of the impact of these 2 commonly used techniques is needed.

MATERIALS AND METHODS

A total of 53 female patients older than 21 years (mean age 45.09) were randomized, using closed envelopes, to undergo TVT or rectus fascia sling. Randomization was performed after patients received spinal anesthesia. One surgeon performed the 2 types of treatment. Associated grade 2 cystocele was simultaneously corrected. Patients with bladder or urethral pathology, as well as those with cystocele greater than grade 2, were excluded from analysis.

RESULTS

All 53 patients completed 6 months of followup and all had stress urinary incontinence. There were 15 patients who underwent sling surgery and 17 who underwent TVT who had concomitant grade 1 or 2 cystocele. No statistically significant difference was found between the 2 groups at baseline. Cure was accomplished in 23 of 25 (92%) with sling and in 26 of 28 (92.9%) with TVT at first followup visit (1 week). There were 7 patients who needed at least 1 extra week of catheterization in the sling group and 3 in the TVT group. No significant difference was detected in terms of post-void residual urine, symptom score, and filling and voiding parameters. At 6 months 1 patient had de novo detrusor overactivity and 7 had wound pain. Compared to those with TVT, 2 cases of sling were considered treatment failures, none had de novo overactivity and 2 had wound pain. None of the patients had symptoms suggestive of urethral erosion.

CONCLUSIONS

Rectus fascia sling and TVT seem to be equally effective regarding primary outcome measure (ie cure of stress incontinence). Symptom score related to incontinence surgery as well as simultaneous correction of cystocele are comparable in the 2 groups. Fascial sling is a longer treatment process yet it is more economical. Longer followup is vital before rigorous conclusions can be drawn.

Authors+Show Affiliations

Urology and Nephrology Center, Mansoura, Egypt. Bassem wadie@mans.edu.egNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16094020

Citation

Wadie, Bassem S., et al. "Autologous Fascial Sling Vs Polypropylene Tape at Short-term Followup: a Prospective Randomized Study." The Journal of Urology, vol. 174, no. 3, 2005, pp. 990-3.
Wadie BS, Edwan A, Nabeeh AM. Autologous fascial sling vs polypropylene tape at short-term followup: a prospective randomized study. J Urol. 2005;174(3):990-3.
Wadie, B. S., Edwan, A., & Nabeeh, A. M. (2005). Autologous fascial sling vs polypropylene tape at short-term followup: a prospective randomized study. The Journal of Urology, 174(3), 990-3.
Wadie BS, Edwan A, Nabeeh AM. Autologous Fascial Sling Vs Polypropylene Tape at Short-term Followup: a Prospective Randomized Study. J Urol. 2005;174(3):990-3. PubMed PMID: 16094020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autologous fascial sling vs polypropylene tape at short-term followup: a prospective randomized study. AU - Wadie,Bassem S, AU - Edwan,Ayman, AU - Nabeeh,Adel M, PY - 2005/8/12/pubmed PY - 2005/9/29/medline PY - 2005/8/12/entrez SP - 990 EP - 3 JF - The Journal of urology JO - J Urol VL - 174 IS - 3 N2 - PURPOSE: The incidence of urinary incontinence in women of childbearing age is about 30%. Around half have stress incontinence. Many treatment modalities have been elucidated to treat stress incontinence, and among the most popular are rectus fascia sling and tension-free vaginal tape (TVT). The introduction of TVT to the urological armamentarium put a multiplicity of synthetic materials into use in the correction of stress urinary incontinence. A comparison of the impact of these 2 commonly used techniques is needed. MATERIALS AND METHODS: A total of 53 female patients older than 21 years (mean age 45.09) were randomized, using closed envelopes, to undergo TVT or rectus fascia sling. Randomization was performed after patients received spinal anesthesia. One surgeon performed the 2 types of treatment. Associated grade 2 cystocele was simultaneously corrected. Patients with bladder or urethral pathology, as well as those with cystocele greater than grade 2, were excluded from analysis. RESULTS: All 53 patients completed 6 months of followup and all had stress urinary incontinence. There were 15 patients who underwent sling surgery and 17 who underwent TVT who had concomitant grade 1 or 2 cystocele. No statistically significant difference was found between the 2 groups at baseline. Cure was accomplished in 23 of 25 (92%) with sling and in 26 of 28 (92.9%) with TVT at first followup visit (1 week). There were 7 patients who needed at least 1 extra week of catheterization in the sling group and 3 in the TVT group. No significant difference was detected in terms of post-void residual urine, symptom score, and filling and voiding parameters. At 6 months 1 patient had de novo detrusor overactivity and 7 had wound pain. Compared to those with TVT, 2 cases of sling were considered treatment failures, none had de novo overactivity and 2 had wound pain. None of the patients had symptoms suggestive of urethral erosion. CONCLUSIONS: Rectus fascia sling and TVT seem to be equally effective regarding primary outcome measure (ie cure of stress incontinence). Symptom score related to incontinence surgery as well as simultaneous correction of cystocele are comparable in the 2 groups. Fascial sling is a longer treatment process yet it is more economical. Longer followup is vital before rigorous conclusions can be drawn. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/16094020/Autologous_fascial_sling_vs_polypropylene_tape_at_short_term_followup:_a_prospective_randomized_study_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000169492.96167.fe?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -