To assess the safety and efficacy of implantation of the sub-urethral tension adjustable sling (Remeex system) in women with stress urinary incontinence (SUI), with or without intrinsic sphincter deficiency (ISD) or detrusor underactivity (DU).METHODS: The study cohort included 100 female patients who underwent Remeex system positioning between May 2002 and July 2008. Patients were evaluated before surgery by physical examination, translabial ultrasonography, flexible cystoscopy, urodynamics, 1-hour pad test and quality-of-life questionnaire. Based on postoperative symptoms, patients were stratified into those who were cured (no symptoms), those who showed improvement (rare incontinence and better than before), and those who failed treatment (no change or worsening of symptoms).RESULTS: At the final follow-up visit, 80 (80%) patients were cured, 11 (11%) were improved and nine (9%) failed treatment. At a mean follow-up period of 15.83AE17.37 months, 64 patients (64%) required sling tension re-adjustment. Complications included intraoperative bladder perforation in 11 (11%) patients, who were easily treated without reoperation, and mesh erosion in two patients (2%), requiring revision under local anesthesia.CONCLUSIONS: The Remeex system was effective in patients with ISD and DU with few and transient complications. Moreover, this system can be modulated even 75 months after surgery.
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