Objective: The purpose of this study was to compare continence rates after placement of rectus fascia or midurethral slings.
Study design: 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.
Results: 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).
Conclusion: Midurethral slings appear to be more effective than rectus fascia slings and are less likely to cause postoperative voiding complications.