The fate of rectus fascia suburethral slings

OBJECTIVE: Autologous rectus fascia is commonly used to construct suburethr al slings for the treatment of genuine stress incontinence. This fascia per forms well and has not been associated with clinical problems related to it s choice as a sling material. However, the histologic appearance of such sl ings after implantation has not been documented. STUDY DESIGN: At the time of revision of autologous rectus fascia suburethr al slings in 5 patients, biopsy specimens of the slings were obtained and s ubmitted for histologic examination. A specimen of rectus fascia before imp lantation was also obtained from a sixth patient who had no symptoms. RESULTS: After implantation autologous rectus fascia slings remain viable. There is fibroblast proliferation. neovascularization, and remodeling of th e graft. No evidence of inflammatory reaction or of graft degeneration was detected. A linear orientation of connective tissue and fibroblasts was see n in some areas, whereas other areas had remodeled to form tissue similar t o noninflammatory scar. CONCLUSION: Autologous rectus iascia slings undergo extensive remodeling af ter implantation.