Korean J Urol.  2014 Feb;55(2):124-128. 10.4111/kju.2014.55.2.124.

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

Affiliations
  • 1Department of Urology, Kwangju Christian Hospital, Gwangju, Korea. urojh@medimail.co.kr

Abstract

PURPOSE
We 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 METHODS
This 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.
RESULTS
The 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.
CONCLUSIONS
After 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.

Keyword

Intrinsic sphincter deficiency; Stress; Urinary incontinence

MeSH Terms

Female*
Follow-Up Studies
Humans
Parity
Questionnaires
Recurrence*
Suburethral Slings
Telephone
Urinary Incontinence*
Urinary Retention

Reference

1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21:167–178.
2. Paick JS, Ku JH, Shin JW, Son H, Oh SJ, Kim SW. Tension-free vaginal tape procedure for urinary incontinence with low Valsalva leak point pressure. J Urol. 2004; 172(4 Pt 1):1370–1373.
3. Lee KS, Choo MS, Doo CK, Han DH, Lee YS, Kim JY, et al. The long term (5-years) objective TVT success rate does not depend on predictive factors at multivariate analysis: a multicentre retrospective study. Eur Urol. 2008; 53:176–182.
4. Schierlitz L, Dwyer PL, Rosamilia A, Murray C, Thomas E, De Souza A, et al. Three-year follow-up of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency. Obstet Gynecol. 2012; 119(2 Pt 1):321–327.
5. Costantini E, Lazzeri M, Giannantoni A, Bini V, Vianello A, Kocjancic E, et al. Preoperative Valsalva leak point pressure may not predict outcome of mid-urethral slings. Analysis from a randomized controlled trial of retropubic versus transobturator mid-urethral slings. Int Braz J Urol. 2008; 34:73–81.
6. O'Connor RC, Nanigian DK, Lyon MB, Ellison LM, Bales GT, Stone AR. Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure. Neurourol Urodyn. 2006; 25:685–688.
7. Yoo DH, Noh JH. Readjustable sling procedure for the treatment of female stress urinary incontinence with intrinsic sphincter deficiency: preliminary report. Korean J Urol. 2010; 51:420–425.
8. Moreno Sierra J, Marques Queimadelos A, Arano Beltran P, De La Fuente Perez P, Cerezuela Requena JF, Cortes Otero E, et al. Spanish registry of the TRT Reemex system in women with stress urinary incontinence (SUI). Arch Esp Urol. 2006; 59:169–174.
9. Errando C, Rodriguez-Escovar F, Gutierrez C, Baez C, Arano P, Villavicencio H. A re-adjustable sling for female recurrent stress incontinence and sphincteric deficiency: Outcomes and complications in 125 patients using the Remeex sling system. Neurourol Urodyn. 2010; 29:1429–1432.
10. Giberti C, Gallo F, Cortese P, Schenone M. The suburethral tension adjustable sling (REMEEX system) in the treatment of female urinary incontinence due to 'true' intrinsic sphincter deficiency: results after 5 years of mean follow-up. BJU Int. 2011; 108:1140–1144.
11. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996; 7:81–85.
12. Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010; 183:1906–1914.
13. Petros PE, Ulmsten UI. An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl. 1993; 153:1–93.
14. Nilsson CG, Kuuva N, Falconer C, Rezapour M, Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2001; 12:Suppl 2. S5–S8.
15. Doo CK, Hong B, Chung BJ, Kim JY, Jung HC, Lee KS, et al. Five-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence. Eur Urol. 2006; 50:333–338.
16. Deffieux X, Donnadieu AC, Porcher R, Gervaise A, Frydman R, Fernandez H. Long-term results of tension-free vaginal tape for female urinary incontinence: follow up over 6 years. Int J Urol. 2007; 14:521–526.
17. Nilsson CG, Falconer C, Rezapour M. Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol. 2004; 104:1259–1262.
18. Leboeuf L, Tellez CA, Ead D, Gousse AE. Complication of bowel perforation during insertion of tension-free vaginal tape. J Urol. 2003; 170(4 Pt 1):1310.
19. Zilbert AW, Farrell SA. External iliac artery laceration during tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct. 2001; 12:141–143.
20. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol. 2001; 11:1306–1313.
21. Mellier G, Benayed B, Bretones S, Pasquier JC. Suburethral tape via the obturator route: is the TOT a simplification of the TVT? Int Urogynecol J Pelvic Floor Dysfunct. 2004; 15:227–232.
22. Schierlitz L, Dwyer PL, Rosamilia A, Murray C, Thomas E, De Souza A, et al. Effectiveness of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency: a randomized controlled trial. Obstet Gynecol. 2008; 112:1253–1261.
23. Guerette NL, Bena JF, Davila GW. Transobturator slings for stress incontinence: using urodynamic parameters to predict outcomes. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19:97–102.
24. Lee JH, Cho MC, Oh SJ, Kim SW, Paick JS. Long-term outcome of the tension-free vaginal tape procedure in female urinary incontinence: a 6-year follow-up. Korean J Urol. 2010; 51:409–415.
25. Nitti VW, Carlson KV, Blaivas JG, Dmochowski RR. Early results of pubovaginal sling lysis by midline sling incision. Urology. 2002; 59:47–51.
26. Wheeler TL 2nd, Richter HE, Greer WJ, Bowling CB, Redden DT, Varner RE. Predictors of success with postoperative voiding trials after a mid urethral sling procedure. J Urol. 2008; 179:600–604.
27. Amaye-Obu FA, Drutz HP. Surgical management of recurrent stress urinary incontinence: a 12-year experience. Am J Obstet Gynecol. 1999; 181:1296–1307.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr