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Abstract

Background: Stress urinary incontinence (SUI) has a substantial effect on women’s quality of life. Common treatment is surgical intervention, including synthetic mesh and autologous fascial slings, both with advantages and limitations.
Objective: To compare the efficacy, operative outcomes, and patient recovery between synthetic mesh and autologous fascial slings in the surgical management of SUI.
Material and Methods: The study was performed as a randomized controlled trial in Department of Urology Shalamar Hospital Lahore, from January 2023 to June 2024 and consisted of 318 female patients with SUI, randomly assigned to: the Synthetic Mesh group (n = 159) or the Autologous Fascia group (n = 159). The key outcomes were success rates, operative time, length of hospital stay and postoperative pain on the visual analog scale (VAS) at 24 hours. Independent t tests and chi square tests were conducted to determine statistically significant differences from p value ≤ 0.05.
Results: The Synthetic Mesh group showed a significantly higher success rate (93.1%) compared to the Autologous Fascia group (78.0%, p < 0.001). Operative time (49.82 ± 9.91 minutes vs. 88.95 ± 13.22 minutes), hospital stay duration (2.01 ± 0.47 days vs. 4.08 ± 1.06 days), and postoperative pain scores (3.08 ± 0.92 vs. 5.10 ± 1.58, p < 0.001) were significantly better in the Synthetic Mesh group. Subgroup analyses by age, obesity status, and parity consistently favored the synthetic mesh.
Conclusion: Performance of synthetic mesh slings is superior to autologous fascial slings for SUI treatment because of superior efficacy, lower morbidity, and speedier recovery. In selected cases, however, autologous slings remain a valid alternative