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Experimental Evaluation of Free Versus Pedicled Fascial Flaps for Sling Surgery of Urinary Stress Incontinence

1997; Lippincott Williams & Wilkins; Volume: 157; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(01)65137-1

1527-3792

Eleftherios Fokaefs, A. Lampel, Markus Hohenfellner, Matthias Lazica, Joachim W. Thüroff,

Urological Disorders and Treatments

No AccessJournal of UrologyInvestigative Urology1 Mar 1997Experimental Evaluation of Free Versus Pedicled Fascial Flaps for Sling Surgery of Urinary Stress Incontinence Eleftherios D. Fokaefs, Alexander Lampel, Markus Hohenfellner, Matthias Lazica, and Joachim W. Thuroff Eleftherios D. FokaefsEleftherios D. Fokaefs More articles by this author , Alexander LampelAlexander Lampel More articles by this author , Markus HohenfellnerMarkus Hohenfellner More articles by this author , Matthias LazicaMatthias Lazica More articles by this author , and Joachim W. ThuroffJoachim W. Thuroff More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65137-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Bladder neck suspension using an autologous fascial sling is an established surgical technique for treatment of urinary stress incontinence. However, the biological fate and physical properties of autologous fascial sling yet remain to be determined. Materials and Methods: Our study was designed to evaluate in an animal model of twenty rabbits fascial slings from free and pedicled fascial flaps of two different widths (7 mm and 15 mm.) and uniform length (60 mm.) in respect to changes of length, width, tensile strength and histological criteria of vitality and integrity 3 months after surgery. Results: The results 3 months after surgery revealed shrinkage in length by 37% (31%-46%) of the original length, shrinkage in width by 63% (60%-69%) of the original width and reduction of tensile strength of 53% (51%-55%) without consistent differences between free and pedicled flaps or 7 mm. and 15 mm. wide flaps. In the groups with 7 mm. wide flaps a total of two dystrophic slings (1 pedicled, 1 free) were seen; however, no dystrophies were seen in 15 mm. wide flaps. On microscopy, all slings were vital regardless of their surgical configuration. Conclusions: In summary, on macroscopic, microscopic and physical examination no gross differences between free and pedicled slings could be detected, so that preferences for use of free or pedicled fascial flaps could not be established for clinical applications in sling surgery. However, 15 mm. wide flaps had a lower incidence of dystrophy and retained greater absolute tensile strength than 7 mm. wide flaps. References 1 : Sling procedures. In: Surgery of Female Incontinence. Edited by . Heidelberg: Springer-Verlag1980: 69. Google Scholar 2 : Zur operativen Beseitigung der Augelborenen Incontinenz Vesicae. Ztsch. f. Gynak. u. Urol.1910; 2: 187. Google Scholar 3 : Transplantation of fascia for relief of urinary stress incontinence. Amer. J. Obst. Gynec.1942; 44: 398. Crossref, Google Scholar 4 : Pubovaginal sling procedure for stress incontinence. J. Urol.1978; 139: 82. 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Google Scholar Department of Urology and Pediatric Urology, Klinikum Barmen, University of Witten/Herdecke, Medical School, Wuppertal, Germany© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLONG LIN A, WANG S, CHEN K and CHANG L (2018) IN VIVO TENSION SUSTAINED BY FASCIAL SLING IN PUBOVAGINAL SLING SURGERY FOR FEMALE STRESS URINARY INCONTINENCEJournal of Urology, VOL. 173, NO. 3, (894-897), Online publication date: 1-Mar-2005.DORA C, DIMARCO D, ZOBITZ M and ELLIOTT D (2018) Time Dependent Variations in Biomechanical Properties of Cadaveric Fascia, Porcine Dermis, Porcine Small Intestine Submucosa, Polypropylene Mesh and Autologous Fascia in the Rabbit Model: Implications for Sling SurgeryJournal of Urology, VOL. 171, NO. 5, (1970-1973), Online publication date: 1-May-2004.WALTER A, MORSE A, LESLIE K, ZOBITZ M, HENTZ J and CORNELLA J (2018) Changes in Tensile Strength of Cadaveric Human Fascia Lata After Implantation in a Rabbit Vagina ModelJournal of Urology, VOL. 169, NO. 5, (1907-1910), Online publication date: 1-May-2003.GOLDMAN H, RACKLEY R and APPELL R (2018) THE IN SITU ANTERIOR VAGINAL WALL SLING: PREDICTORS OF SUCCESSJournal of Urology, VOL. 166, NO. 6, (2259-2262), Online publication date: 1-Dec-2001. Volume 157Issue 3March 1997Page: 1039-1043 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Eleftherios D. Fokaefs More articles by this author Alexander Lampel More articles by this author Markus Hohenfellner More articles by this author Matthias Lazica More articles by this author Joachim W. Thuroff More articles by this author Expand All Advertisement PDF downloadLoading ...