Department of Female and Functional Urology, Fundacio Puigvert, Barcelona, Spain.
Neurourol Urodyn. 2010 Nov;29(8):1429-32. doi: 10.1002/nau.20879.
To evaluate the outcomes, complications, and quality of life of patients after a Remeex re-adjustable sling for recurrent stress urinary incontinence (SUI) and intrinsic sphincteric deficiency (ISD) indications.
One hundred twenty-five patients with SUI were prospectively evaluated following a re-adjustable sling in a single tertiary academic Center. Patients were classified by Q-tip, urodynamic and clinical criteria into ISD (70) and recurrent SUI (55). All patients underwent a re-adjustable sling placement. Outcome measures included pad-test, urodynamics, and the King's Health Questionnaire.
After a mean follow-up of 38 months (26-72), 109 patients (87%) are cured of SUI based on pad-test, clinical, and urodynamic criteria. Sixteen patients (13%) remain incontinent. Nine of those (7%) are satisfied to the point that they decline re-adjustment of the sling, and seven (6%) are on the waiting list for re-adjustment. Nineteen patients show urge incontinence (9 with previous urodynamic mixed incontinence, 10 (8%) with de novo detrusor overactivity). Twenty-one patients benefited from a re-adjustment of the sling during the follow-up. The tension was increased in 17 cases (continent at discharge) due to recurrence of SUI, and reduced in 4 due to obstruction. The Varitensor was removed in 1 case due to infection. No other complications were seen.
The Remeex re-adjustable sling system provides a good cure rate for recurrent SUI and ISD with a low complication rate. The ability to increase or decrease sling tension allowed us to achieve cure in patients who were not initially dry, and to relieve obstruction in every case attempted.
评估 Remeex 可调节吊带治疗复发性压力性尿失禁（SUI）和固有括约肌缺陷（ISD）患者的结局、并发症和生活质量。
在一家三级学术中心，前瞻性评估了 125 例接受可调节吊带治疗的 SUI 患者。根据 Q-tip、尿动力学和临床标准，将患者分为 ISD（70 例）和复发性 SUI（55 例）。所有患者均行可调节吊带置入术。结局评估包括垫试验、尿动力学检查和 King's 健康问卷。
平均随访 38 个月（26-72 个月）后，根据垫试验、临床和尿动力学标准，109 例（87%）患者治愈 SUI。16 例（13%）仍有尿失禁。其中 9 例（7%）对治疗结果满意，拒绝再次调整吊带，7 例（6%）在等待再次调整吊带的名单上。19 例患者出现急迫性尿失禁（9 例为先前混合性尿动力学逼尿肌过度活动，10 例为新发逼尿肌过度活动）。21 例患者在随访期间受益于吊带调整。17 例（出院时尿控）因 SUI 复发而增加吊带张力，4 例因梗阻而减少吊带张力。1 例因感染而取出 Varitensor。未观察到其他并发症。
Remeex 可调节吊带系统治疗复发性 SUI 和 ISD 的治愈率高，并发症发生率低。增加或减少吊带张力的能力使我们能够治愈最初未治愈的患者，并缓解每例尝试的梗阻。
