A re‐adjustable sling for female recurrent stress incontinence and intrinsic sphincteric deficiency: Long‐term results in 205 patients using the Remeex sling system

Errando‐Smet, Carlos; Ruiz, Cristina Gutiérrez; Bertrán, Pedro Arañó; Mavrich, H. Villavicencio

doi:10.1002/nau.23444

Cited by 16 publications

(20 citation statements)

References 20 publications

(25 reference statements)

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“…In addition, 80.0% of patients were very satisfied or satisfied with the operation results at the 1-year follow-up. In addition, recent published research results are summarized in Table 4 [19202122232425]. In the current study, the short-term results of 70 patients with SUI (64 cases of SUI due to ISD and 6 recurrent SUI cases) who underwent REMEEX surgery revealed a subjective cure rate of 92.9% and an objective cure rate of 100%.…”

Section: Discussionmentioning

confidence: 53%

Readjustable midurethral sling (REMEEX system) in obese women

Kim

Lee

et al. 2019

Investig Clin Urol

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PurposeTo evaluate the success rate and patient satisfaction with the readjustable midurethral sling (REMEEX system) for the treatment of stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) or recurrent SUI in obese and non-obese women.Materials and MethodsBetween August 2009 and August 2015, 70 patients who treated with the REMEEX system were stratified into normal, overweight and obesity groups according to body mass index. Objective surgical outcomes were evaluated using a 1-hour pad test that was performed 3 months after surgery. The subjective outcomes and degree of patient satisfaction were evaluated 3 months and 1 year after surgery.ResultsTwenty-six normal weight, 31 overweight, and 13 obese women were included in the study. The objective cure rate determined using the 1-hour pad test revealed that 11 women (42.3%) were cured and 15 (57.7%) had improved in the normal weight group, respectively, compared with 16 (51.6%) and 15 (48.4%) in the overweight group and 6 (46.2%) and 7 (53.8%) in the obese group, respectively (p=0.78). One year after surgery, the subjective success rate was 91.5% in the normal weight group, 93.5% in the overweight group and 92.3% in the obese group. A total of 84.7%, 77.4%, and 77.0% of normal weight, overweight and obese women were very satisfied or satisfied 1 year after surgery, respectively. All groups showed similar success rates and satisfaction.ConclusionsThe REMEEX procedure is equally effective in obese and normal weight women with ISD-type SUI or recurrent SUI.

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Section: Discussionmentioning

confidence: 53%

Readjustable midurethral sling (REMEEX system) in obese women

Kim

Lee

et al. 2019

Investig Clin Urol

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“…According to our department's clinical practice, all patients underwent urodynamic evaluation after the surgery. As some patients required sling tension readjustment during follow‐up, 8 postoperative urodynamics were performed once the last regulation had been done and after the final continence status had been achieved. Both pre‐ and postoperative urodynamic tests were performed and reported according to the International Continence Society (ICS) recommendations 14 .…”

Section: Methodsmentioning

confidence: 99%

“…[1][2][3] Several studies have demonstrated the usefulness of the Remeex® readjustable sling in rSUI [4][5][6][7][8] and ISD. [4][5][6][7][8][9] Outcomes of this procedure have previously been reported by our group, showing good results in terms of continence, with a low complication rate. 8 Although voiding dysfunction has been described as a potential complication after sling placement surgery, 10,11 it has also been suggested that some degree of bladder outlet obstruction could be related to a higher continence rate.…”

Section: Introductionmentioning

confidence: 99%

Is bladder outlet obstruction responsible for a successful surgical outcome in women with complicated stress urinary incontinence? Urodynamic results before and after a Remeex® readjustable sling

Arrom

Rubio

Palou

et al. 2021

Neurourology and Urodynamics

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Aims To describe the changes in urodynamic parameters after Remeex® placement in women with recurrent stress urinary incontinence (rSUI) or intrinsic sphincteric deficiency (ISD) and to analyze a potential relationship between postoperative bladder outlet obstruction and a successful surgical outcome. Methods Retrospective analysis of those women who had undergone Remeex® placement due to rSUI or ISD in our department between 2000 and 2017. All patients underwent urodynamic evaluation before and after the surgery. If tension readjustment was required, postoperative urodynamics was performed after the last regulation, once the final continence status had been achieved. The female Bladder Outlet Obstruction Index (BOOIf) was calculated for all patients postoperatively. Obstruction was considered present if BOOIf was >18. Pre‐ and postoperative urodynamic variables were compared. Postoperative urodynamic changes were also compared between cured and noncured patients. Results A total of 205 women were included. After a follow‐up of 89 ± 36 months, 165 women (80.5%) were continent. A significant impairment in the majority of the urodynamic parameters was observed. Mean postoperative BOOIf was −11.8 ± 21.5 in cured patients and −15.3 ± 23.1 in noncured patients (p = 0.365); 15 (9.1%) patients in the cured group had a postoperative BOOIf >18, whereas all (100%) patients in the noncured group had a postoperative BOOIf <18. Conclusions Most urodynamic parameters may worsen after the Remeex® system placement. Postoperative urodynamic parameters may not differ substantially between cured and noncured patients, although a certain grade of bladder outlet obstruction could be related to postoperative continence status in some patients.

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“…A retrospective study for Remeex re-adjustable sling, which was conducted to the 205 patients after primary failure of MUS, revealed 71.7% of cure rates during a mean follow up of 89 months . 88 patients (42.9%) required re-adjustment (82 cases of tension increase and 6 cases of tension reduction) [46]. Compared with the standard sling, re-adjustable sling seems to result in increased success rates and decreased complications as a salvage procedure because of readjusting the inadequate tension, which could induce recurrence of incontinence or postoperative bladder outlet obstruction.…”

Section: A C C E P T E Dmentioning

confidence: 99%

Second-Line Surgical Management After Midurethral Sling Failure

Kwon

Kim

2021

Int Neurourol J

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Currently, midurethral sling is widely used as a standard treatment in stress urinary incontinence (SUI) patients. According to several studies, the failure rate of midurethral sling (MUS) has been reported to be approximately 5-20%. In general, the sling failure can be defined as the state that SUI persists even after the surgery or that incontinence is improved temporarily and then recurs. Additionally, it can be widely regarded as a failure that the cases requiring secondary surgery due to mesh exposure, postoperative voiding difficulty, de novo urgency/urge incontinence, and severe postoperative pain, etc.Because of the lack of a large-scale study with high quality, there has been no clear guideline for second-line management yet. To date, transurethral bulking agent injection, tape shortening, repeat MUS, pubovaginal sling (PVS) using autologous fascia, and Burch colposuspension are available options for second-line surgery. Repeat MUS is the most widely used method as a second-line surgery at present. Bulking agent injection has lower durability and efficacy compared to other treatments. Tape shortening demonstrates a relatively lower success rate but comparable outcome if the period from first treatment to relapse is short. In patients with intrinsic sphincter deficiency (ISD), PVS and retropubic (RP) MUS can be considered first as second-line management because of higher success rate compared to other treatments. When revision or reoperation is required due to prior meshrelated complications, PVS or colposuspension, which is performed without a synthetic mesh, is appropriate for the second-line surgery. For the patient with detrusor underactivity, the readjustable sling can be a better option because of the high risk of postoperative voiding dysfunction in PVS or RP sling.

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A re‐adjustable sling for female recurrent stress incontinence and intrinsic sphincteric deficiency: Long‐term results in 205 patients using the Remeex sling system

Cited by 16 publications

References 20 publications

Readjustable midurethral sling (REMEEX system) in obese women

Readjustable midurethral sling (REMEEX system) in obese women

Is bladder outlet obstruction responsible for a successful surgical outcome in women with complicated stress urinary incontinence? Urodynamic results before and after a Remeex® readjustable sling

Second-Line Surgical Management After Midurethral Sling Failure

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