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Ajust single incision transobturator sling procedure for stress urinary incontinence: results after 1-year follow-up

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Abstract

Introduction and hypothesis

Data on the Ajust™, a new single-incision sling procedure for female stress urinary incontinence (SUI) management, remain scarce and limited to a 1-year follow-up. Our goal was to assess the efficacy of this procedure after a 1-year follow-up.

Methods

This prospective evaluation involved 95 consecutive patients implanted with AjustTM at a single centre. All patients had SUI on urodynamics due to urethral hypermobility, 33 % had preoperative overactive bladder (OAB) symptoms and none had detrusor overactivity. Ninety-two patients were treated on an outpatient basis, and 3 patients had general anaesthesia. Postoperative assessment was conducted at 1, 6, 12 months, and yearly thereafter. The main outcome measure was pad usage. Secondary parameters were self-reported SUI episodes, OAB symptoms, data of clinical examination, satisfaction using the Patient Global Impression of Improvement (PGI-I) scale, postoperative pain, and adverse events.

Results

After a mean follow-up of 21 ± 6 months (12–32), 76 out of 95 patients used no pads or one dry security pad, showing a success rate of 80 %. Seventy-nine out of 95 patients had no more SUI-related leakage. Only 6 patients experienced late recurrence of SUI after 6 months’ follow-up. Perioperative complications included 1 case of vaginal hematoma, 1 case of acute urinary retention, 2 cases of urinary tract infection, all managed conservatively. Half of the patients had no pain after day 1, free of medications. Late complications were vaginal erosion in 1 case, and pain during exertion in 2 cases.

Conclusions

The AjustTM single incision transobturator sling is a safe and effective procedure, with durable results after 1 year.

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Conflicts of interest

J.N. Cornu: none; L. Peyrat: none; A. Skurnik: none; C. Ciofu: none; V.R. Lucente: consultant and lecturer for Bard; F. Haab: consultant for Bard.

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Authors and Affiliations

  1. Department of Urology, Groupe Hospitalo-Universitaire EST, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris VI, Tenon Hospital, Paris, France

    Jean-Nicolas Cornu, Laurence Peyrat, Calin Ciofu & Francois Haab

  2. Hospital Pitié-Salpêtrière, Groupe Hospitalo-Universitaire EST, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris VI, Paris, France

    Ariela Skurnik

  3. Department of Urology, The Institute for Female Pelvic Medicine & St. Luke’s Hospital, 2200 West Hamilton Street, Suite 111, Allentown, PA, 18104, USA

    Vincent R. Lucente

  4. Urology Department, Tenon Hospital, 4 rue de la Chine, 75970, Paris CEDEX 20, France

    Jean-Nicolas Cornu

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  1. Jean-Nicolas Cornu
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  2. Laurence Peyrat
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  3. Ariela Skurnik
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  4. Calin Ciofu
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  5. Vincent R. Lucente
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  6. Francois Haab
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Correspondence to Jean-Nicolas Cornu.

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Cornu, JN., Peyrat, L., Skurnik, A. et al. Ajust single incision transobturator sling procedure for stress urinary incontinence: results after 1-year follow-up. Int Urogynecol J 23, 1265–1270 (2012). https://doi.org/10.1007/s00192-012-1740-0

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  • DOI: https://doi.org/10.1007/s00192-012-1740-0

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