No abstract

As a treatment option for refractory idiopathic OAB, at 10 years, SNM provides a considerable possibility of symptom and quality-of-life improvement and is cost-effective compared to BoNT-A or continued OMT.

The Remeex re-adjustable sling system provides a good cure rate for recurrent SUI and ISD with a low complication rate. The ability to increase or decrease sling tension allowed us to achieve cure in patients who were not initially dry, and to relieve obstruction in every case attempted.

No abstract

Surgery for stress urinary incontinence (SUI) in women with previous interventions is often difficult and yields poor results. A total of 33 women with recurrent SUI underwent placement of a polytetrafluoroethylene (PTFE) sling after a mean of 1.5 (range, 1-3) unsuccessful operations. Preoperative bladder instability (BI) was ruled out in all cases. The patients' mean age was 54 (range, 34-79) years. In all, 64% had SUI and 36% had SUI and incontinence at rest. The Aldrige-Stoeckel technique is used with insertion of a 2 x 30 c m sling instead of fascia lata. M e a n operating time was r e d u c e d in 40 minutes. After a mean follow-up period of 13 months, 72% of the patients achieved continence without retention (complete success). Altogether, 16 patients (48%) required self-catheterization after discharge, with the voiding imbalance lasting for more than 3 months in only 4 cases (12% of the total). Three patients underwent surgery for outlet obstruction. There were five abdominal wound infections but no vaginal wound infection. Two slings have since been removed (one partially), but none has eroded through the urethra. The P T F E sling is a reasonable option for this group of patients. Retention is usually selflimited, and most complications can be managed successfully.The pubovaginal sling procedure as an intervention for stress urinary incontinence (SUI) was described initially by Goebel in 1910 [5] and by Stoeckel in 1917 [12]. A modification of the technique using fascia lata and the pyramidal muscle was introduced by Aldridge in 1942 [ 1]. Since then, multiple technical variations and different materials have been described [4, 7, 10, 11, 14]. We report our experience with the first 33 patients presenting with recurrent SUI after undergoing other surgical procedures in w h o m a polytetrafluoroethylene (PTFE) sling was placed.