The Effectiveness and Satisfaction of Modified Fascial Sling Operation Using Allograft Fascia in Stress Urinary Incontinence: Comparison with Autologous Fascia

Lee, Jae Hwan; Lee, Jong Bouk

Abstract

PURPOSE: We retrospectively evaluated and compared the success rate, and satisfaction with the operation, in patients who had undergone the modified fascial sling procedure using autologous and allograft fascia.
MATERIALS AND METHODS
We compared 65 consecutive women (44%), having undergone the modified fascial sling procedure using allograft cadaveric fascia lata between September 1999 and April 2002 (group 1), with 82 consecutive women (56%), having undergone the procedure using autologous rectus fascia between December 1996 and August 1999 (group 2). The surgical outcomes, and the satisfaction of patients, were assessed by questionnaire.
RESULTS
In group 1 the mean follow-up was 26 months (range 12-32), and 59 (91%) of the patients were cured, and 4 (6%) improved. In group 2, the mean follow-up was 51 months (range 32-64), and 73 (90%) of the patients were cured, and 6 (7%) improved. From the questionnaires, there was no difference in the satisfaction with the operation between the groups, but was somewhat lower than the success rate. The mean operation time for group 1 was significantly shorter than for group 2, and postoperative pain control in group 1 was significantly less than in group 2. De novo urge incontinence developed in 2 (3.1%) and 3 (3.7%) patients from groups 1 and 2, respectively.
CONCLUSIONS
The modified fascial sling procedure, using allograft fascia, was more advantageous because of the decreased operation time and the reduction in pain control, although there were no significant differences in the success rates and satisfaction between the two groups. Therefore, the modified fascial sling procedure, using allograft fascia, is an effective treatment for all types of stress urinary incontinence, with a high cure rate and an acceptable low morbidity. A longer follow-up period will be required to confirm our results.