Currently, more than 40 different types of synthetic slings are used to treat stress urinary incontinence (SUI).  However, mesh-associated complications related to the use of polypropylene nets have been accumulating in recent years (erosion of perurethral tissues, dyspareunia, hyperactivity of the bladder de novo).  Searching the optimal implant for surgical treatment SUI is significant.  A promising solution is hybrid slings, in which biological component is placed in the most vulnerable middle part of the implant.  The presence of allogaft "Alloplant" in hybrid slings allow carry out standard technique of transobturator sling operation without increasing time duration. 
Objective: The aim of our work is to improve the results of the operative treatment of female SUI with the use of hybrid allogeneic-synthetic suburethral slings and prevention implant-associated complications.

This prospective study included on 100 female patients with SUI hospitalized to the Clinic of Bashkir State Medical University. Patients were categorized into two groups: Group I included 50 patients whom a midurethral sling procedure using hybrid tape is implanted; Group II included 50 patients whom a synthetic transobturator tape was implanted during  transobturator sling operation (in both groups). Patients completed the PGI and UDI-6 questionnaires and underwent urodynamic studies before surgery and six months after surgery. MRI and 3D ultrasound were performed postoperatively at 3, 6, and 12 months.

Both groups showed comparable and significant improvements in the questionnaires.  The average operation time of Group 1 and 2 was 28.33±6.1 min and 22.7±3.5 min respectively.  The cure rate was 98% in group 1 and 96% in group 2, which was not statistically significant.  Serious intraoperative complications were not observed.  Vaginal erosion was observed in one case in group II, which was treated by sling removal. One case of bladder hyperactivity de novo was observed in group II .  According to the MRI of the small pelvic organs, there were signs of remodeling and biological transformation of allogeneic material in group II, which indicates the formation of functionally complete connective tissue structure on the recipient site, which able to withstand static and dynamic loads.

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A hybrid sling prosthesis is an economically efficient, feasible, safe and effective surgical alternative to midurethral sling The fixation properties of the synthetic mesh for better tension control are preserved, while the periurethral contact zone is maintained with an allogeneic graft.  However, it is still necessary to conduct long-term researches of a large group of patients.