الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Objective: To compare the effectiveness of of pubovaginal sling using autologous rectus fascial flap and tensionfree vaginal tape (TVT) for treatment of stress urinary incontinence (SUI). Patients & Methods: Forty patients with SUI were treated with sling procedure randomly using pubovaginal fascial flap in 18 and TVT in 22. The sling was placed at the mid urethra in either procedure with minimal tension. Time consumed, blood loss during surgery and surgical complications were assessed. All cases were followed one week, 3 and 6 months post operatively both objectively, using urodynamic studies, and subjectively using questionnaire. Results: Cure rates were high in TVT and fascial sling both objectively (95.5% Vs 94.5%) and subjectively (91% Vs 89% respectively). Mean blood loss and operative time were significantly increased in pubovaginal sling group (P=0.024 and 0.01 respectively). Accidental bladder injury occurred in 1 patient (5.5%) in pubovaginal sling group and 2 (9%) in TVT group. De novo detrusor instability occurred in 1 patient (5.5%) in pubovaginal sling group and 1 (4.5%) in TVT group 6 months later that was treated with anticholinergic therapy. Conclusion: Both the pubovaginal fascial sling and TVT were effective in treating SUI with high subjective and objective cure rates. Tensionfree vaginal tape procedure was less time consuming, associated with less blood loss and technically easier but it was costly. Anterior colporrhaphy can be concomitantly done after placement of fascial sling or TVT.