title: Treating stress urinary incontinence in female patients with neuropathic bladder: the value of the autologous fascia rectus sling.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of the autologous fascia rectus sling in treating stress urinary incontinence in female patients with neuropathic bladder. Furthermore, correlations between preoperative parameters and outcome were evaluated.
  
  
  METHODS
  We retrospectively reviewed operative logs from a single surgeon (EM) of 33 female patients with neuropathic bladder treated over a 3-year period for stress urinary incontinence by implantation of an autologous fascia rectus sling. Efficacy was evaluated objectively in terms of the number of pads used per day, while subjective patient satisfaction was also recorded using a global assessment question. Possible correlations between age, obesity, preoperative Valsalva leak point pressure and incontinence severity and outcome were investigated using univariate analysis.
  
  
  RESULTS
  The mean follow-up time was 52 months, while the mean age of the patients was 37 years. Causes of neuropathic bladder were myelomeningocele in 21 (63.63 %) and spinal cord injury in 12 patients (36.36 %). A total of 30 patients were successfully treated and satisfied with the outcome of the operation (90.9 %). Twenty-five patients (75.75 %) were totally dry, while 5 patients (15.15 %) had markedly improved but still required one pad per day. The complication rate was 15.20 %. Univariate analysis failed to show any correlation between the final outcome and the checked parameters.
  
  
  CONCLUSIONS
  The free autologous rectus fascia sling is a highly effective technique for the treatment of female stress incontinence in patients with neuropathic bladder, while the morbidity is mild.
authors: Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA. tassos_athan@hotmail.com
authors: Anastasios
authors: A
authors: Athanasopoulos
authors: Konstantinos
authors: K
authors: Gyftopoulos
authors: Edward J
authors: EJ
authors: McGuire
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005205:Fascia; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011312:Pressure; D012189:Retrospective Studies; D012720:Severity of Illness Index; D053825:Suburethral Slings / Q000009:adverse effects; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D055815:Young Adult