Stress urinary incontinence (SUI) is one of the distressing problems that affects large numbers of women allover the world The tension-free vaginal tape (TVT) has been established as main surgical  approach for the treatment of SUI Since it was introduced  by Ulmsten et al. in 1996. Despite   TVT procedure was shown to have a high cure rate in the medium and long terms , complications such as bladder injury and  retropubic hematoma resulting from the passage of the sling through the retropubic space and voiding dysfunction have been reported. Despite the popularity of the tension-free vaginal tape procedure via a retropubic approach, using an elastic polypropylene tape for the management of SUI, the overall safety of th synthetic slings have been put under further scrutiny due to the high complication rate weighted against its high long-term success rate . Vaginal and urethral sling erosions are complications unique to synthetic slings  . Hybrid tape is a new technique supposed to avoid the complications of synthetic slings. It is composed of central autologous part which is taken from rectus fascia fixed to two lateral arms of the synthetic mesh
Objective: To compare the clinical and operative outcomes of hybrid tape versus synthetic tapes during mid-urethral sling in treating female stress urinary incontinence (SUI).

Patients and methods: This prospective study included 60 women with SUI. Patients were categorized into two groups: Group I included 30 patients who underwent midurethral sling procedure using hybrid tape; and Group II included 30 patients that had synthetic sling, using trans obturator tape approach (TOT) in both groups . The following variables were compared: operative time, post operative pain scores, duration of indwelling urethral catheter, hospital stay, and QoL assessment (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF]) before and after discharge from hospital.

Results: Patients among the two groups were normally distributed with no statistically significant difference in patient’s demographic data and comorbidities. There was an obvious increase in operative time in group I compared to group II. This increase was statistically highly significant. (p <0.001).

Post operative nocturia, urgency, and urge incontinence rates were not significantly different between in both groups, and these cases were managed by medical treatment. Vaginal sling erosion was encountered in one case in group II which was managed by sling removal.

Conclusion: Hybrid tape should be considered as a treatment option during TOT for female SUI with comparable efficacy and safety to synthetic tape. Long term follow up should be considered.
Keywords: word: female incontinence, synthetic mesh, rectus fascia ,autologous graft , cough stress test