We have used a vaginal graft with removal of the epithelial layer to form a double layer with a polypropylene sling to cure the incontinence
The patient remains well 3 years later.
Have a look at
1. Haverfield M, Petros PE Salvage operation for urethral perforation caused by TVT removal for severe urinary incontinence- a case report. Pelviperineology 2012; 31:27-28
actually i do not have any experience in using fascia lata as a urethral substitute but i think its histology is not ideal because it had no epithelium it is only mesodermal in origin
I guess we need to know exactly what the problem is
If you look at the structure of fascia lata collagen, it is cross-bonded in a linear fashion. That is what makes it stiff and strong. At least in the female, the posterior urethral wall is densely attached to the vagina in its lower part. The 'fascial' layer of vagina, actually smooth muscle, collagen, elastin,is attached to the distal urethral wall. The collagen fibres have a sinuous shape which allows urethra and vagina to be extended together. A fascia lata graft may possibly prevent this action. So purely from a biomechanical perspective, urethral extension is required for micturition and closure. Elasticity is needed in any graft. If you mean a total reconstruction for a destroyed urethra, a vaginal tube won't work. The fistula surgeons I know are using a tube fashioned from bladder wall smooth muscle
Fascia lata graft has been successfully used for closure of urethral fistula secondary to hypospadias repair. However, it seems not suitable for urethral replacement, particularly there is no current data which support this issue.