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Effectiveness of the Remeex system™ in Colombian women with recurrent stress urinary incontinence or intrinsic sphincter deficiency

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Abstract

Introduction and hypothesis

We report our experience with the Remeex system™ in women with recurrent stress urinary incontinence (SUI) or intrinsic sphincter deficiency (ISD).

Methods

A multicenter retrospective study was conducted in women who underwent an adjustable sling procedure between 2011 and 2016. We used urodynamic studies (UDS) preoperatively and the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) and cough stress test (CST) pre- and postoperatively. Primary outcomes were subjective (no leakage reported by the patient) and objective (no leakage during CST) cure and improvement rates (reduction of ≥4 points in ICIQ-SF). Descriptive and inferential statistics were employed.

Results

A total of 50 patients were included. Mean age was 62 years (SD ± 11.35). Median follow-up was 19.5 months [interquartile range (IQR) 12.95–41.38]. Urinary incontinence (UI) was described as moderate and severe by 8 (16%) and 42 (84%) patients, respectively, and 25 (50%) had stress-predominant mixed urinary incontinence (MUI). Objective and subjective cure rates were 90% and 48%, respectively, while 82% of patients achieved improvement. Impact of UI on quality of life (QoL) improved from 10 (IQR 9–10) to 2 (IQR 0–5) (p < 0.0001). Clavien-Dindo II complications occurred in 14 (28%) patients, and one (2%) had IIIa. Tape erosion occurred in one (2%) patient, and five (10%) required readjustments. Logistic regression identified MUI [odds ratio (OR) 3.3, 95% confidence interval (CI) 1.02–10.89] and vaginal atrophy (OR 4.2, 95% CI 1.06–16.03) as predictors of low subjective cure rate.

Conclusions

Adjustable slings represent a valuable and safe option in the management of recurrent SUI or ISD, with improvement in QoL. Results should be carefully interpreted due to our small sample and retrospective design.

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Abbreviations

SUI:

Stress urinary incontinence

ISD:

Intrinsic sphincter deficiency

USD:

Urodynamic studies

CST:

Cough stress test

UI:

Urinary incontinence

MUI:

Mixed urinary incontinence

QoL:

Quality of life

ALPP:

Abdominal leak point pressure

MUCP:

Maximal urethral closure pressure

VAS:

Visual analag scale

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Authors and Affiliations

  1. Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, D.C., Colombia

    Mauricio Plata, Daniela Robledo, Alejandra Bravo-Balado, Carlos Gustavo Trujillo, Juan Ignacio Caicedo & Juan Guillermo Cataño

  2. Department of Urology, Clínica Universitaria CES, Universidad CES and Pontificia Universidad Bolivariana, Medellín, Colombia

    Juan Carlos Castaño

  3. Department of Urology, Clínica Comfamiliar de Risaralda, Pereira, Colombia

    Catalina Osorio

  4. Department of Urology, Fundación Oftalmológica de Santander - Clínica Carlos Ardila Lülle (FOSCAL), Bucaramanga, Colombia

    Milton Salazar

  5. Department of Urology, Clínica Medellín and Universidad CES, Medellín, Colombia

    Juan Guillermo Velásquez

Authors
  1. Mauricio Plata
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  2. Daniela Robledo
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  3. Alejandra Bravo-Balado
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  4. Juan Carlos Castaño
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  5. Catalina Osorio
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  6. Milton Salazar
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  7. Juan Guillermo Velásquez
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  9. Juan Ignacio Caicedo
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Corresponding author

Correspondence to Mauricio Plata.

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Conflict of interest

The corresponding author, Dr. Mauricio Plata, is a speaker and proctor for the following companies: Neomedic, Medtronic, Boston Scientific and Pfizer. Dr. Juan Carlos Castaño is a speaker and proctor for Medtronic and Boston Scientific. The rest of the authors have no conflicts of interest.

Ethical/institutional review board approval

This study was reviewed and approved by the Hospital Universitario Fundación Santa Fe de Bogotá Ethics Committee (CCEI-6460-2016, December 14, 2016)

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Plata, M., Robledo, D., Bravo-Balado, A. et al. Effectiveness of the Remeex system™ in Colombian women with recurrent stress urinary incontinence or intrinsic sphincter deficiency. Int Urogynecol J 29, 1371–1378 (2018). https://doi.org/10.1007/s00192-018-3568-8

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  • DOI: https://doi.org/10.1007/s00192-018-3568-8

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