Medium-term comparison of continence rates after rectus fascia or midurethral sling placement.
OBJECTIVE
The purpose of this study was to compare continence rates after placement of rectus fascia or midurethral slings.


METHODS
We performed a retrospective cohort study of 242 women who underwent rectus fascia (n = 79) or midurethral (n = 163) sling procedures to treat urinary incontinence. Outcome was based on responses to validated questionnaires and need for interim treatment for incontinence. Survival free of incontinence was estimated using the Kaplan-Meier method. Associations between patient factors and survival free of incontinence were evaluated by fitting Cox proportional hazards models.


RESULTS
Women with rectus fascia slings were more likely to report any leakage of urine (P = .04) and were 13 times more likely to require urethrolysis (P < .001) than patients with midurethral slings. Patient satisfaction was lower in the rectus fascia sling group compared with the midurethral sling group (P = .01).


CONCLUSIONS
Midurethral slings appear to be more effective than rectus fascia slings and are less likely to cause postoperative voiding complications.
Trabuco
Emanuel C
EC
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA. trabuco.emanuel@mayo.edu
Klingele
Christopher J
CJ
Weaver
Amy L
AL
McGree
Michaela E
ME
Lightner
Deborah J
DJ
Gebhart
John B
JB
D015331:Cohort Studies; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D017060:Patient Satisfaction; D011126:Polypropylenes; D011183:Postoperative Complications / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000601:surgery*
D011126:Polypropylenes