Outcome in 104 pubovaginal slings using freeze-dried allograft fascia lata from a single tissue bank.
We describe our experience with the use of allograft fascia lata for the treatment of stress urinary incontinence. One hundred and four patients underwent allograft fascia lata pubovaginal slings. Preoperatively, all were evaluated by a detailed urogynecologic evaluation, voiding diary, and pelvic examination. The pubovaginal sling was performed using a 2x15-cm freeze-dried nonirradiated cadaveric fascia lata specimen. Outcome measures were assessed by a urogynecologic questionnaire, pad usage, and disease-specific quality-of-life questionnaires. Eighty-eight percent (91 of 104) responded to a mailed urogynecology and disease-specific quality-of-life questionnaire with an average follow-up period of 19. 4 +/- 10.3 months. The mean preoperative daily pad usage was 4.6 +/- 3.0, postoperatively pad usage was 1.1 +/- 1.4 (P < 0.0001). Urge incontinence resolved in 41% (n = 24) of the 59 patients who complained of this preoperatively. Eighty-seven percent of the responders indicated that urinary incontinence was not substantially affecting their daily life. As in our preliminary report, the use of freeze-dried allograft pubovaginal sling continues to provide good results without adverse outcomes. A prospective, randomized comparison of autologous versus allograft slings and a review of preparation techniques used by tissue banks are needed.
Amundsen
C L
CL
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA. amund002@mc.duke.edu
Visco
A G
AG
Ruiz
H
H
Webster
G D
GD
D000368:Aged; D002102:Cadaver; D003559:Cystostomy / Q000379:methods; D005206:Fascia Lata / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D011859:Radiography; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000601:surgery*; D014563:Urodynamics