A randomised controlled trial comparing two autologous fascial sling techniques for the treatment of stress urinary incontinence in women: short, medium and long-term follow-up

Abstract

This randomised control trial compares full-length autologous slings (Group A: 81 women) with a modified "sling-on-a-string" (Group B: 84 women) technique for the treatment of stress urinary incontinence (SUI). Primary outcomes are quality of life (QoL) scores; Group A/Group B. The IIQ-7 scores decrease from 1.91/1.85 at baseline to 0.65/0.72 at 12 months and 0.85/0.92 at +5 years. The UDI-6 scores decrease from 1.85/1.61 at baseline to 0.66/0.62 at 12 months and 1.22/1.08 at +5 years. The incidence of SUI is 13% at 3 months but averages 53% at +5 years. Both techniques offer similar improvements. The shorter sling is quicker, less painful and with less hospital readmissions. The 'sling-on-a-string' technique is as effective as the standard technique with better short-term sequelae. The incidence of SUI post-autologous slings rises over the long term.

Outcomes of autologous fascial slingplasty procedure for treating female urinary incontinence

“…However, the autologous sling requires the harvesting of fascia, which may increase operative time, morbidity, the cost of the procedure, and postoperative recovery time or hospitalization [16]. In this study, we used a short strip of rectus fascia for the slingplasty, which was supposed to lower the operative time and minimize postoperative morbidity because less fascia was harvested compared to the usual full length (20 cm) strip for a fascia sling [17]. Some investigators have reported recurrent urinary incontinence after a pubovaginal slingplasty of over 25% [5,7].…”

Comparison of candidate scaffolds for tissue engineering for stress urinary incontinence and pelvic organ prolapse repair

“…Meta‐analysis has shown that non‐absorbable synthetic meshes have a lower objective prolapse recurrence rate than absorbable meshes, 8.8 vs. 23.1%, but the rate of erosion was higher, 10.2 vs 0.7%, respectively . Autografts have the disadvantage of donor site morbidity and reduced long‐term success rates but do not lead to a foreign body reaction and rarely cause erosion . Cadaveric allografts have shown high medium‐term failure rates .…”

A randomised controlled trial comparing TVTTM, PelvicolTM and autologous fascial slings for the treatment of stress urinary incontinence in women

“…Many alternative materials and devices are now available by which a mid‐urethral sling can be performed, e.g., different polypropylene mesh kits, xenografts or cadaveric fascia. However, there remains little prospective comparative data to assist surgeons in making the choice between the bewildering range of new techniques and materials available 4–6 …”

“…This current study was conceived to compare autologous fascia, 6 a biological porcine dermal graft and a type‐1 polypropylene mesh as materials for the performance of mid‐urethral slings.…”