Premium
Failure of allograft suburethral slings
Author(s) -
Fitzgerald,
Mollenhauer,
Linda Brubaker
Publication year - 1999
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.1999.00246.x
Subject(s) - fascia lata , medicine , sling (weapon) , surgery , stress incontinence , urinary incontinence
Objectives To report our experience of using freeze‐dried irradiated fascia lata allografts for suburethral sling procedures. Patients and methods Between December 1996 and September 1998, 35 patients (mean age 60.25 years, range 37–79) underwent suburethral sling placement with fascia allograft. These patients were reviewed, with the findings at the time of any surgical re‐exploration. Eleven (31%) had undergone prior surgery for genuine stress incontinence and 32 (91%) had a preoperative diagnosis of intrinsic sphincter deficiency. Results On re‐operation for persistent or recurrent stress incontinence, the allograft was present but grossly degenerated in two (6%) patients and completely absent in five (14%) patients. Histology of a retrieved graft fragment showed both fibroblast proliferation and degeneration within the graft. Conclusion The use of freeze‐dried, irradiated fascia lata for suburethral sling procedures was associated with a material failure rate of ≥20%. We caution against its use in this setting.