Long-term Outcome of the Readjustable Sling Procedure for Female Stress Urinary Incontinence With Intrinsic Sphincter Deficiency or Recurrence

Abstract

PurposeWe evaluated the long-term outcome of a readjustable midurethral sling system (Remeex) in the treatment of recurrence of stress urinary incontinence (SUI) after surgical treatment or SUI with intrinsic sphincter deficiency (ISD).Materials and MethodsThis study included 19 patients who underwent the Remeex procedure with a mean of 45.6 months of follow-up. The patients had responded to a telephone questionnaire. Thirteen patients had ISD, four patients had SUI recurrence, and two patients had both. The questionnaire included subjective cure and satisfaction surveys and also recommended surgery to some patients.ResultsThe mean patient age was 69.1 years (range, 50-85 years), the mean parity was 2.79 times (range, 2-5 times), and the mean follow-up period was 45.6 months (range, 21-72 months). The long-term follow-up cure rate was 79%, the improvement rate was 21%, and the fail rate was 0%. The long-term follow-up "very satisfactory" rate was 26.3%, the "satisfactory" rate was 73.7%, and the "usual" and "unsatisfactory" rates were both 0%. In addition to these results, 16 patients (84.2%) would recommend the Remeex procedure to other patients with SUI recurrence or ISD. After the procedure, four patients had urinary retention, three patients had difficulty emptying, and one patient had SUI recurrence. Furthermore, all of the patients subsequently endured sling readjustments.ConclusionsAfter long-term follow-up, the Remeex system showed good cure rates and subjective satisfaction rates that were similar to the results found at the 1-year follow-up, and minimal complications were reported. Therefore, the Remeex system is effective in treating patients with SUI recurrence or ISD.

Mid‐ to long‐term results of the Remeex system for the treatment of female incontinence due to intrinsic sphincter deficiency: A retrospective analysis of the first 50 patients

“…The aim of this paper was to evaluate the role of the suburethral tension adjustable sling procedure for the treatment of urinary incontinence due to ISD in a larger series of patients with a longer follow‐up than previously reported in literature. In fact, although the latest papers regarding the Remeex technique, including our experience, have reported cure rates higher than 80%, the small number of patients studied (mainly between 20 and 30 cases) or the rather limited follow‐up periods (not more than 5 years) tended to downsize the importance of these outcomes . A larger series of patients was only published by Errando et al, who showed a cure rate of 86% in 70 patients.…”

“…In fact, although the latest papers regarding the Remeex technique, including our experience, have reported cure rates higher than 80%, the small number of patients studied (mainly between 20 and 30 cases) or the rather limited follow-up periods (not more than 5 years) tended to downsize the importance of these outcomes. [21][22][23] A larger series of patients was only published by Errando et al, who showed a cure rate of 86% in 70 patients. However, the reported follow-up was less than 3 years.…”

Efficacy and safety of a readjustable midurethral sling (Remeex system) for stress urinary incontinence with female voiding dysfunction

“…Recently, tension-free midurethral sling procedures have been used widely for SUI. Owing to the evolution of midurethral slings and their high efficacy and safety, retropubic midurethral slings and transobturator midurethral slings have been introduced into numerous urologic fields [ 3 ]. However, procedures using these 2 slings have a weakness: appropriate tension cannot be determined during the operation.…”