Pubovaginal sling using cadaveric allograft fascia for the treatment of female urinary incontinence

The technique and outcomes of patients treated with allografts or autografts as pubovaginal sling are compared. Fascia lata was included among the tissues harvested from brain-dead patients considered for multiple organ donation. After informed consent, segments of allograft (group A) cadaveric fascia lata autografts (group B) were compared with used for sling operations in 60 women from 37 to 73 years of age (mean 53.4 years), who presented with stress incontinence requiring a pubovaginal sling. At a mean follow-up of 36 months (range = 22 to 44 months), 40% of group A patients were cured and 28% were improved. At a mean follow-up of 33 months (range = 24 to 41) 70% of group B patients were cured and 20% improved ( P < .05). There were no adverse outcomes of sling erosion or infection in either group. Placement of allograft sling took an average of 62 minutes while the mean duration of sling placement requiring fascial harvest was 81 minutes ( P < .05). The mean duration of hospital stay was shorter in the allograft (1.25 days) than the autograft (2.48 days) group ( P < .05). Use of allografts was associated with a shorter operative time and duration of hospital stay compared to an autograft, but the 3-year continence rate was lower in the autograft group.