Medium-term comparison of continence rates after rectus fascia or midurethral sling placement

The purpose of this study was to compare continence rates after placement of rectus fascia or midurethral slings.

We performed a retrospective cohort study of 242 women who underwent rectus fascia (n = 79) or midurethral (n = 163) sling procedures to treat urinary incontinence. Outcome was based on responses to validated questionnaires and need for interim treatment for incontinence. Survival free of incontinence was estimated using the Kaplan-Meier method. Associations between patient factors and survival free of incontinence were evaluated by fitting Cox proportional hazards models.

Women with rectus fascia slings were more likely to report any leakage of urine (P = .04) and were 13 times more likely to require urethrolysis (P < .001) than patients with midurethral slings. Patient satisfaction was lower in the rectus fascia sling group compared with the midurethral sling group (P = .01).

Midurethral slings appear to be more effective than rectus fascia slings and are less likely to cause postoperative voiding complications.