Use of autologous rectus fascia in a new transobturator hybrid sling for treatment of female stress urinary incontinence: a pilot study.
OBJECTIVE
This article reports the early results of a novel sling used for the treatment of female stress urinary incontinence (SUI). This sling has a piece of autologous rectus fascia in its middle part and two arms of polypropylene mesh.


METHODS
The study included 44 women with SUI. The preoperative work-up involved complete history taking, physical examination, cough stress test (CST) and 1 h pad weight test (PWT). Two questionnaires, the Urogenital Distress Inventory - Short Form (UDI-6) and the Incontinence Impact Questionnaire - Short Form (IIQ-7), were also completed preoperatively. The previously described sling was then inserted via the transobturator route in all patients. Postoperatively, the previous work-up was repeated for objective evaluation of the procedure and the subjective improvement was assessed by the Patient Global Impression of Improvement scale.


RESULTS
At the end of the first year, 92.9% of the patients had a negative CST, 85.7% had 1 h PWT <1 g and the subjective cure rate was 90.5%. In addition, the scores for both UDI-6 and IIQ-7 were found to be decreased significantly (p < 0.001). The recorded complications included temporary urinary retention, dyspareunia, de novo urge incontinence and groin pain in 4.8%, 4.8%, 7.1% and 11.9% of patients, respectively.


CONCLUSIONS
This hybrid sling appears to have good short-term efficacy and low cost.
Urology Department, Tanta University Hospital, Tanta, Egypt.
Osama
O
El-Gamal
Mohamed
M
Soliman
Ahmad
A
Tawfik
Ali
A
Abdel Raheem
D000328:Adult; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology; D005205:Fascia; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017699:Pelvic Pain / Q000453:epidemiology / Q000209:etiology; D010865:Pilot Projects; D011126:Polypropylenes; D017568:Rectus Abdominis / Q000601:surgery; D053825:Suburethral Slings / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology; D014563:Urodynamics / Q000502:physiology
D011126:Polypropylenes