Incontinence Research Today is a free monthly online journal that collates and summarizes the latest research about Incontinence, including details on urinary incontinence, bladder control, treatment, causes.

Comparison of autologous rectus fascia and cadaveric fascia in pubovaginal sling continence outcomes.

Howden NS, Zyczynski HM, Moalli PA, Sagan ER, Meyn LA, Weber AM

Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Pittsburgh Health Sciences Center, Magee-Womens Hospital, Pittsburgh, PA, USA.

OBJECTIVE: The purpose of this study was to compare autologous versus cadaveric grafts in pubovaginal slings. STUDY DESIGN: Women who had pubovaginal slings from 1994 to 2003 completed history, questionnaires, prolapse staging, and cough stress testing. Failure was defined by recurrent urinary incontinence symptoms and reoperation for stress incontinence. Group differences were evaluated using Student t test or chi-square test. The log-rank test was used to evaluate time to failure between the groups. RESULTS: Of 303 women enrolled, 153 had autologous and 150 had cadaveric grafts. Regular urine leakage (39.6% vs 28.3%, P = .04) and reoperation for stress incontinence (12.7% vs 3.3%, P = .003) occurred more in the cadaveric versus autologous group, respectively. Adjusting for differing follow-up times, the cadaveric versus autologous group experienced higher rates of urinary incontinence (16 vs 5 per 100 women-years, P < .0001) and higher rates of reoperation (4 vs 1 per 100 women-years, P < .0003). CONCLUSION: Autologous grafts used in pubovaginal slings have superior continence outcomes compared with cadaveric fascia.

Published 1 May 2006 in Am J Obstet Gynecol, 194(5): 1444-9.
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