The aim of the study was to compare of outcome of a classic pubovaginal sling (PVS) using autologous rectus fascial (ARF) and Tension Free Vaginal (TVT) suprapubic arc (SPARC) sling using polyvinylidene fluoride (PVDF) tape, for the treatment of females with stress urinary incontinence (SUI).

We prospectively included women with severe SUI in the study. We scheduled the follow-up program at 1, 6, 12, 24 and 36 months postoperatively. Data on the subjective success rate were collected by comparing the scores of the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Long form (ICIQ_FLUTS LF) at baseline and postoperative follow-ups. Objective outcomes were investigated by Pad test and cough test, too.
The overall success rate and frequency of the complications, the incidence of each complication, and  the severity of the complications based on the Clavien-Dindo classification were compared between the two groups after at least a follow-up of 36 months.

Between January 2012 and December 2023, 166 women with severe SUI underwent a sling procedure. The final analysis was based on 125 women, with 73 in the PVDF-sling group and 52 in the PVS group. The mean follow-up time was 41 months in the PVDF-sling group and 38 months in the PVS group. The operative duration was significantly lower in the PVDF-sling group (32.44 ± 4.04 vs 91.08 ± 7.74 minutes, P value = 0.000). SUI disappeared or improved in more than 90% of patients in both groups, and these cure rates were similar to those obtained 1 year after surgery. Success rates were 93% in the PVDF-sling group and 94% in the PVS group. The overall complication rate was 47.2% in the PVS group compared to 25% in the PVDF-sling group (P value = 0.049). Grade 2 complications according to the Clavien-Dindo classification occurred more frequently in the PVS group (P value = 0.042). ICIQ FLUTS scores improved for both groups with no significant difference between complications.

Our 3-year data indicate that compared to the classic rectus fascial -PVS method the PVDF sling tape has initial positive findings for efficacy. PVDF tape was associated with low rates of foreign body reaction in this population of patients and in comparison, the autologous PVS had the same success rate. PVDF tapes are biocompatible material for mid-urethral slings, but further studies of long-term follow-up should be performed to confirm these preliminary data

Our 3-year data indicate that compared to the classic rectus fascial -PVS method the PVDF sling tape has initial positive findings for efficacy. PVDF tape was associated with low rates of foreign body reaction in this population of patients and in comparison, the autologous PVS had the same success rate. PVDF tapes are biocompatible material for mid-urethral slings, but further studies of long-term follow-up should be performed to confirm these preliminary data

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