The fate of rectus fascia suburethral slings.
OBJECTIVE
Autologous rectus fascia is commonly used to construct suburethral slings for the treatment of genuine stress incontinence. This fascia performs well and has not been associated with clinical problems related to its choice as a sling material. However, the histologic appearance of such slings after implantation has not been documented.


METHODS
At the time of revision of autologous rectus fascia suburethral slings in 5 patients, biopsy specimens of the slings were obtained and submitted for histologic examination. A specimen of rectus fascia before implantation was also obtained from a sixth patient who had no symptoms.


RESULTS
After implantation autologous rectus fascia slings remain viable. There is fibroblast proliferation, neovascularization, and remodeling of the graft. No evidence of inflammatory reaction or of graft degeneration was detected. A linear orientation of connective tissue and fibroblasts was seen in some areas, whereas other areas had remodeled to form tissue similar to noninflammatory scar.


CONCLUSIONS
Autologous rectus fascia slings undergo extensive remodeling after implantation.
FitzGerald
M P
MP
Division of Urogynecology and Pelvic Reconstructive Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL, USA.
Mollenhauer
J
J
Brubaker
L
L
D000368:Aged; D001808:Blood Vessels / Q000473:pathology / Q000503:physiopathology; D002455:Cell Division; D003238:Connective Tissue / Q000473:pathology; D005205:Fascia / Q000098:blood supply / Q000473:pathology / Q000637:transplantation*; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D011184:Postoperative Period; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*