Vl. Handa et al., BANKED HUMAN FASCIA LATA FOR THE SUBURETHRAL SLING PROCEDURE - A PRELIMINARY-REPORT, Obstetrics and gynecology, 88(6), 1996, pp. 1045-1049
Objective: To report our initial experience with allogenic (human cada
ver donor) fascia lata for the suburethral sling procedure. Methods: A
llogenic fascia lata for the suburethral sling procedure has been used
in our practice since July 1994. Fascial grafts were obtained from li
censed tissue banks. Women who underwent this procedure were followed
prospectively to determine the incidence of perioperative complication
s, the incidence of local wound complications at the sling insertion s
ite, and the subjective and objective cure rates. Results: Sixteen wom
en underwent the suburethral sling procedure with allogenic fascia. Fo
urteen had genuine stress urinary incontinence and two required replac
ement of a previously placed synthetic graft because of chronic infect
ion. Follow-up ranged from 6 months to 1 year. No patient developed si
nus tract formation or persistent granulation tissue. Two of 16 patien
ts (12%) developed abdominal wound infections, which resolved with loc
al care. The mean duration of postoperative bladder drainage was 29 da
ys. One patient continued to require intermittent catheterization at 1
87 days. Among the 14 women with preoperative genuine stress incontine
nce, the subjective cure rate was 86% and the objective cure rate was
79%. The two patients who required replacement of a chronically infect
ed synthetic graft remained subjectively continent. Conclusions: These
preliminary data suggest that allogenic fascia lata is an acceptable
material for the suburethral sling procedure. This material may be con
sidered as an alternative to autologous fascia, which must be harveste
d from the patient intraoperatively, and to synthetic materials, which
have been associated with local complications in up to 40% of cases.
(Copyright (C) 1996 by The American College of Obstetricians and Gynec
ologists.)