Comparative study of polypropylene and aponeurotic slings in the treatment of female urinary incontinence

Abstract

Purpose: Female stress urinary incontinence (SUI), the involuntary leakage of urine, is a highly prevalent social and hygiene problem, and various surgical techniques have been developed to correct it. This study used the technique of an aponeurosis sling made from the rectus abdominis muscle as a standard and compared the technique to a sling made with a polypropylene mesh, (Marlex®). Materials and Methods: From 2000 to 2007, 158 women who underwent surgery for SUI with an aponeurosis sling, (average age 55 years), were used as a standard for comparison with 316 women who underwent surgery with a polypropylene sling (average age 55 years). Results: The mean follow-up period was 3.65 and 3.56 years for the respective groups. The aponeurosis group showed a cure of SUI in 128 (81.0%), improvement in 23 (14.6%), and failure in 7 (4.4%). The polypropylene group showed a cure in 281 (88.9%), improvement in 23 (7.3%), and failure in 10 (3.2%) (p = 0.083). Urgency was observed in 19 (12%) of the aponeurosis group, and 28 (8.9%) in the polypropylene group (p = 0.320). Conclusions: This study showed that the polypropylene mesh is an effective alternative to construct a sling for SUI in women. The results and rates of complication were comparable to the fascial sling from the rectus abdominis muscle aponeurosis.