title: Comparison of the efficacy and safety of surgical procedures utilizing autologous fascial and transobturator slings in patients with stress urinary incontinence.
abstract: OBJECTIVE
  To evaluate whether the conventional autologous fascial (AF) sling is superior or equal to the readjustable transobturator (TOT) sling in efficacy and safety in women with stress urinary incontinence (SUI).
  
  
  METHODS
  This was a retrospective study comprised of a sample of 463 patients from 2003 to 2009. A total of 203 women received TOT slings for urodynamically confirmed SUI, and 260 patients received AF slings. We analyzed the subjective success rate (cure and/or improvement) after 12 and 24 months of surgery as well as any immediate and late surgical complications.
  
  
  RESULTS
  Both groups were statistically similar with regard to age, parity, body mass index, number of previous gynecological surgeries, and antiincontinence therapies. After 12 months patients with the TOT sling had a higher subjective percentage efficacy rate when compared to those with the AF sling (94% vs. 88%, p < 0.05); however, after 24 months this percentage was no longer statistically significant (88.7% vs. 84.6%, p = 0.20). The TOT sling presented fewer postoperative complication rates (14.1% vs. 25.6%, p < 0.05), similar intraoperative complication rates (1.15% vs. 2.3%, p = 0.22) and a shorter mean operative time (23 vs. 112 minutes, p < 0.05) than the AF sling.
  
  
  CONCLUSIONS
  Both techniques had similar subjective efficacy rates, but the TOT sling demonstrated fewer postoperative surgical complications than the AF sling.
authors: Division of Urogynecology, Gynecological and Reconstructive Pelvic Surgery, Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, São Paulo University, Brazil. lgobrito@gmail.com
authors: Luiz Gustavo Oliveira
authors: LG
authors: Brito
authors: Heitor Leandro Paiva
authors: HL
authors: Rodrigues
authors: Maria Angela Cury Ramos
authors: MA
authors: Carvalho
authors: Pedro Sérgio
authors: PS
authors: Magnani
authors: Alessandro Henrique Antunes
authors: AH
authors: Lopes
authors: Maurício Mesquita
authors: MM
authors: Sabino-de-Freitas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D011475:Prosthesis Failure; D017568:Rectus Abdominis / Q000637:transplantation*; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries; D001743:Urinary Bladder / Q000293:injuries; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology