Korean J Urol.  2010 Jun;51(6):420-425.

Readjustable Sling Procedure for the Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency: Preliminary Report

• Yoo DH
• Noh JH

Abstract

PURPOSE
The Remeex (Mechanical External Regulation) sling is a mid-urethral sling that allows adjustment of the sling tension in the postoperative period. We evaluated the early outcomes of the procedure in patients in whom the success rate of tension-free slings is low, such as with intrinsic sphincter deficiency (ISD).
MATERIALS AND METHODS
We included 17 women with urodynamically proven stress urinary incontinence (SUI) who underwent the Remeex procedure and were followed for at least 12 months. The patients were considered to have ISD on the basis of a Valsalva leak point pressure (VLPP) <60 cmH2O or a maximum urethral closure pressure (MUCP) <20 cmH2O. We analyzed parameters including history taking, urodynamic study (UDS), and postoperative clinical outcomes. Patient's success and satisfaction rates were evaluated after the procedure. Also, we asked about lower urinary tract symptoms (LUTSs) with a questionnaire, and the severity of LUTSs was assessed with the Visual Analog Scale (VAS) before and 12 months after the operation.
RESULTS
The patients' mean age was 55.6+/-9.58 years. Four (23.5%) patients had mixed incontinence. Five patients (29.4%) had undergone previous surgery for SUI. At a mean follow-up of 13.3 months (range, 12-16 months), 14 patients (82.3%) were cured and 3 patients (17.6%) were improved. Four patients (23.5%) answered very satisfied and 13 patients (76.4%) answered satisfied on the satisfaction questionnaire. Also, LUTSs were improved except voiding pain (p<0.05).
CONCLUSIONS
This procedure provides high cure and satisfaction rates. Our results demonstrate that the Remeex procedure is suitable for women with SUI with ISD.

Keyword

Stress urinary incontinence; Suburethral slings

MeSH Terms

Female
Follow-Up Studies
Humans
Lower Urinary Tract Symptoms
Postoperative Period
Suburethral Slings
Urinary Incontinence
Urodynamics

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