Recommendations for the treatment of stress urinary incontinence (SUI) due to intrinsic sphincteric deficiency (ISD) or recurrent, are complex. They accept the use of sub-urethral slings (BSU), if unsuccessful the artificial urinary sphincter. The objective was to report the results in terms of continence and morbidity of the Remeex® Adjustable BSU in the treatment of SUI by ISD recurrent or non-recurrent.
Monocentric retrospective study of 70 patients with a mean age of 67.7 years (±12) operated of Remeex sling, between 2015 and 2019, was conducted. Preoperative and postoperative characteristics were analyzed from medical records. Two groups were analyzed: Group A (n=28) with no history of incontinence surgery and Group B (n=42) with history (recurrent). Patients who were totally continent (0 protection) and those who were socially continent (1 safety protection) were considered successful.
Postoperative success rate was similar between groups B (90 %) and A (92%) with respectively: 64% versus 71% of totally continent patients, 26% versus 21% wearing safety protection. The postoperative complications were mainly Clavien II (28%) such as urinary tract infections (6%), transient urinary retention (3%) and de novo bladder overactivity (20%) with no significant statistical difference between the groups. Six patients were reoperated (Clavien III): BSU detension (1%), vaginal exposure (4%) (including one total material removal for infection), varitensor explantation (1%) or scar disunion (1%).
The Remeex® BSUA seems to lead to satisfactory perioperative results in patients with SUI with ISD recurrent or non-recurrent.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 Jan 10 [Epub ahead of print]
Morgane Flochlay, Elsa Bey, Elodie Bruneaux, Emilien Seizilles de Mazancourt, Laurent Wagner
Service d'Urologie et Andrologie CHU de Nîmes, Univ Montpellier, Nîmes, France. Electronic address: ., Service d'Urologie et Andrologie CHU de Nîmes, Univ Montpellier, Nîmes, France., Service d'Urologie, Chirurgie de la transplantation, Hospices Civils de Lyon, France.