Objective: This study was undertaken to compare Tension-Free Vaginal tape (TVT) with Rectus Sheath Sling as the primary treatment for stress urinary incontinence.

Patients and Methods: Fifty-seven consecutive patients, with a mean age of 34.3+/- 9.6 years and affected by SUI, were included in this randomized controlled study. After preoperative assessment, patients were randomly allocated to the TVT or Rectus Sheath sling procedure. Operative time, perioperative complications, and hospital stay were prospectively recorded. Cure of SUI was defined as no leakage of urine during the stress test at urodynamic testing. Patients were followed up for 5 years, 48 complete evaluations and 9 lost during follow up.

Results: All patients were evaluable at the 5 years follow-up. The characteristics of
Patients were well balanced between groups after randomization. The mean operative time was significantly shorter in the TVT group. Perioperative complications, intraoperative blood loss, hospital stays, and time to return to normal activities were insignificantly differing between both groups. Forty-Eight patients out of 57 patients (84.2%) were successfully followed up for 5 years after the operation with success (88.2% and 85.7% for TVT and rectus sheath sling groups, respectively).

Forty-Eight patients out of 57 patients (84.2%) were successfully followed up for 5 years after the operation with success (88.2% and 85.7% for TVT and rectus sheath sling groups, respectively).

Conclusions: Treatment of urinary incontinence by TVT is a reliable, mini-invasive, reproducible technique, almost suitable for outpatients, with no serious complications; it is very successful, including in complicated cases such as sphincter deficiency. With this 5-year follow-up, both techniques TVT and rectus sheath sling appear to be equally effective in the surgical treatment of SUI. However, TVT had insignificantly a shorter operative time hospital stays, and time to return to normal activities than rectus sheath sling.