Urethral slings have emerged as the procedure of choice for the surgical correction of most types of female urinary stress incontinence. 
In 1997, the Female Stress Urinary Incontinence Clinical Guidelines Panel of the American Urological Association analyzed the literature regarding surgical procedures for treating stress urinary incontinence and established that retropubic suspensions and sling procedures were the most durable procedures with the longest outcome for dryness
Slings are used to treat patients with intrinsic sphincter deficiency or type III urinary incontinence and patients in whom other procedures for stress urinary incontinence have failed. Recently, slings have been recommended for all types of stress urinary incontinence as a first-line procedure 
This study was undertaken to compare long-term outcome of Tension-Free Vaginal tape (TVT) with Rectus Sheath Sling as the primary treatment for stress urinary incontinence.

Patients and Methods: Fifty-six consecutive patients, with a mean age of 34.3+/- 9.6 years and affected by SUI, were included in this randomized controlled study. After preoperative assessment, patients were randomly allocated to the TVT or Rectus Sheath sling procedure. Operative time, perioperative complications, and hospital stay were prospectively recorded. Cure of SUI was defined as no leakage of urine during the stress test and at urodynamic testing. Patients were followed up for 5 years, 48 complete evaluations and 8 lost during follow up

Results: All patients were evaluable at the 5 years follow-up. The characteristics of
Patients were well balanced between groups after randomization. The mean operative time was significantly shorter in the TVT group. Perioperative complications, intraoperative blood loss, hospital stays, and time to return to normal activities were insignificantly differing between both groups. Forty-Eight patients out of 56 patients (84.2%) were successfully followed up for 5 years after the operation with success (88.5% and 84.6% for TVT and rectus sheath sling groups, respectively).

As regard the Urodynamic parameters in our study there is marked improvement of abdominal leak point pressure in both groups with insignificant deference   between both. This consistent with Hsieh et al, [39] .Also in our study there was marked objective improvement of both abdominal leak point pressure and stress urethral closure pressure, which maintained for fife years this is consistent with  Tsia-Shu Lo and Shu-Jane Lee

Conclusion: Treatment of urinary incontinence by TVT is a reliable, mini-invasive, reproducible technique, almost suitable for outpatients, with no serious complications; it is very successful, including in complicated cases such as sphincter deficiency. With this 5-year follow-up, both techniques TVT and rectus sheath sling appear to be equally effective in the surgical treatment of SUI. However, TVT had insignificantly a shorter operative time hospital stays, and time to return to normal activities than rectus sheath sling.
Keywords: TVT; Rectus Sheath Sling;Stress urinary incontinence