Long-term evaluation of rectus fascial wrap in patients with spina bifida

Purpose: We evaluated patients with spina bifida to determine long-term results of the rectus fascial wrap, a modification of the rectus fascial sling. Materials and Methods: We assessed patients with spina bifida 3 years after a rectus fascial wrap procedure using an outcome questionnaire, renal ultrasound and urodynamics. Results: The 15 patients who completed the outcome questionnaire indicated that significant improvement over preoperative status was maintained a mean of 58 months postoperatively. Ultrasound in 14 cases showed no postoperative increase in hydronephrosis. Urodynamic study in 13 patients revealed a mean bladder capacity of 583 cc and mean maximum detrusor pressure of 39 cm. water, while 11 had no urine leakage when Valsalva leak point pressure was measured. Conclusions: Three years postoperatively the rectus fascial wrap provides dryness comparable to that of other bladder neck sling procedures in patients with spina bifida.