Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment
Purpose: To examine efficacy and safety of ReMEEX implantation in patients with female stress urinary incontinence (SUI) associated with detrusor underactivity (DU), recurrence, or intrinsic sphincter deficiency (ISD). Materials and Methods: Retrospective cohort study included 303 females who under...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2024-03-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20230283 |
| _version_ | 1797271391932776448 |
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| author | Hwanik Kim Jin Hyuck Kim Seong Jin Jeong |
| author_facet | Hwanik Kim Jin Hyuck Kim Seong Jin Jeong |
| author_sort | Hwanik Kim |
| collection | DOAJ |
| description | Purpose: To examine efficacy and safety of ReMEEX implantation in patients with female stress urinary incontinence (SUI) associated with detrusor underactivity (DU), recurrence, or intrinsic sphincter deficiency (ISD).
Materials and Methods: Retrospective cohort study included 303 females who underwent ReMEEX system (March 2008 to May 2021). Patients were stratified into three groups by purpose of surgery (SUI with DU, reoperation, and SUI with ISD) and evaluated with following criteria: cure (absence of subjective complaint of leakage and objective leakage in the stress test), improvement (rare leakage subjectively, but satisfaction regardless of stress test), and failure. Primary outcome was success rate of surgery assessed through patient interviews and a stress test. Surgical outcomes and complications were evaluated.
Results: Mean follow-up was 34.4 months (range, 6.0–145.0 months). At the final follow-up visit, 42.9% and 49.2% of patients were cured and improved. Twenty-one point five percent required tension readjustment (mean number, 1.2). The total complication rate was 19.5% (none for grade ≥4). Preoperative Qmax was significantly higher in the ISD group (p<0.001) and preoperative total International Prostate Symptom Score (IPSS) score was significantly higher in the DU group (p=0.044). Moreover, at postoperative 1 year, both total IPSS score and IPSS quality of life score were significantly higher in the DU group (both p=0.001).
Conclusions: The success rate of ReMEEX system was 92.1% at mean follow-up of 34.4 months in female SUI with DU, reoperation, or ISD. It also enabled postoperative readjustment of sling tension, as needed, up to 130 months after surgery. |
| first_indexed | 2024-03-07T14:03:02Z |
| format | Article |
| id | doaj.art-66a69a1a6fa247ba86e62210df93ba9e |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-03-07T14:03:02Z |
| publishDate | 2024-03-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-66a69a1a6fa247ba86e62210df93ba9e2024-03-07T04:43:55ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2024-03-0165215716410.4111/icu.20230283Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustmentHwanik Kim0https://orcid.org/0000-0001-5201-2490Jin Hyuck Kim1https://orcid.org/0000-0002-8702-7008Seong Jin Jeong2https://orcid.org/0000-0002-3580-1452Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.Purpose: To examine efficacy and safety of ReMEEX implantation in patients with female stress urinary incontinence (SUI) associated with detrusor underactivity (DU), recurrence, or intrinsic sphincter deficiency (ISD). Materials and Methods: Retrospective cohort study included 303 females who underwent ReMEEX system (March 2008 to May 2021). Patients were stratified into three groups by purpose of surgery (SUI with DU, reoperation, and SUI with ISD) and evaluated with following criteria: cure (absence of subjective complaint of leakage and objective leakage in the stress test), improvement (rare leakage subjectively, but satisfaction regardless of stress test), and failure. Primary outcome was success rate of surgery assessed through patient interviews and a stress test. Surgical outcomes and complications were evaluated. Results: Mean follow-up was 34.4 months (range, 6.0–145.0 months). At the final follow-up visit, 42.9% and 49.2% of patients were cured and improved. Twenty-one point five percent required tension readjustment (mean number, 1.2). The total complication rate was 19.5% (none for grade ≥4). Preoperative Qmax was significantly higher in the ISD group (p<0.001) and preoperative total International Prostate Symptom Score (IPSS) score was significantly higher in the DU group (p=0.044). Moreover, at postoperative 1 year, both total IPSS score and IPSS quality of life score were significantly higher in the DU group (both p=0.001). Conclusions: The success rate of ReMEEX system was 92.1% at mean follow-up of 34.4 months in female SUI with DU, reoperation, or ISD. It also enabled postoperative readjustment of sling tension, as needed, up to 130 months after surgery.https://www.icurology.org/pdf/10.4111/icu.20230283mid-urethral slingprosthesis adjustmenturinary incontinence stress |
| spellingShingle | Hwanik Kim Jin Hyuck Kim Seong Jin Jeong Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment Investigative and Clinical Urology mid-urethral sling prosthesis adjustment urinary incontinence stress |
| title | Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment |
| title_full | Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment |
| title_fullStr | Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment |
| title_full_unstemmed | Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment |
| title_short | Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment |
| title_sort | mid term results of remeex sling system in female stress urinary incontinence with various indications and feasibility of readjustment |
| topic | mid-urethral sling prosthesis adjustment urinary incontinence stress |
| url | https://www.icurology.org/pdf/10.4111/icu.20230283 |
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