Objective: To evaluate the use of Goretex pubovaginal sling and compare the results with a typical indigenous material graft made of rectal fascia. Methods: We have prospectively evaluated 48 consecutive patients in a randomized fashion in whom a sling procedure was performed to treat their type III incontinence. Sixteen women had a vesicourethral suspension(VUS) by a Goretex sling and another group of 32 patients, comparable in age range and medium age with the previous group, had a similar VUS by a sling from the rectus abdominis fascia. Both groups were evaluated urodynamically 6 and 30 months later. Results: In the first group, cure of incontinence was observed in 87.5% and in the remaining patients it was significantly improved. In 2 patients there was an erosion of the urethra and the Goretex sling had to be removed 3.5 years later. Three other women remained dry but complained of occasional irritative symptoms. In the remaining 11 there was no erosion and the excellent postoperative result was maintained. In the group with fascial slings there was no erosion observed and in general they had less irritative symptoms. Cure or improvement of incontinence was comparable with the first group when studied 6 months after surgery, but there was a significant difference in the 30 months postoperative evaluation. Conclusions: Use of a Goretex sling provides better long-term results even though it is associated with somewhat increased morbidity.

Keywords:
Goretex sling, Rectus fascia sling, Allogenic graft, Indigenous graft, Type III stress urinary incontinence, Urodynamic evaluation, Suburethral slings
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1997
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