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A re‐adjustable sling for female recurrent stress incontinence and intrinsic sphincteric deficiency: Long‐term results in 205 patients using the Remeex sling system
Author(s) -
ErrandoSmet Carlos,
Ruiz Cristina Gutiérrez,
Bertrán Pedro Arañó,
Mavrich Humberto Villavicencio
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23444
Subject(s) - medicine , sling (weapon) , urinary incontinence , surgery , stress incontinence , patient satisfaction , cure rate , urology
Aims To evaluate the outcomes and complications at long‐term follow‐up after a Remeex re‐adjustable sling for recurrent stress urinary incontinence (rSUI) and intrinsic sphincteric deficiency (ISD) in women. Methods Two hundred thirty women with SUI were evaluated after undergoing a re‐adjustable sling operation. Twenty‐five patients were lost to follow‐up, 205 were classified by Q‐tip, urodynamic, and clinical criteria into ISD (109) and rSUI (96). Outcome measures included number of pads, 1 h pad‐test, urodynamics and subjective satisfaction index with the procedure. Results After a mean follow‐up of 89 months (26‐159), 165 patients were cured of SUI (71.7% in the intention to treat analysis (itt), 80.5% in per protocol analysis (pp)). Forty patients remained incontinent (17.4% in itt, 19.5 in pp). Thirty‐one patients (15.1%) had detrusor overactivity (DH) incontinence, 21 (10.2%) with de‐novo DH and 10 with previous urodynamic mixed incontinence. Eighty‐eight patients required re‐adjustment of the sling during the follow‐up. The tension was increased in 82 cases due to recurrence of SUI and reduced in six due to outlet obstruction. The overall complications rate was 28.8%, (3.4% clavien III). Conclusions The Remeex re‐adjustable sling provides a good cure rate for rSUI and ISD at long‐term follow‐up. The complications rate is acceptable since most complications are clavien II. The ability to re‐adjust the sling tension during the follow‐up allowed us to achieve cure for recurrence after the initial procedure, and to relieve obstruction in every case attempted.