title: Adjustable suburethral sling (male remeex system) in the treatment of male stress urinary incontinence: a multicentric European study.
abstract: OBJECTIVE
  To evaluate the effectiveness of a readjustable sling for the treatment of male stress urinary incontinence (SUI).
  
  
  METHODS
  Between October 2002 and August 2005, 51 male patients with mild to severe SUI were prospectively operated with the use of a readjustable sling (MRS) at seven different European hospitals: Spain (2), Italy (2), Greece (1), Germany (1), and Portugal (1). The origin of incontinence was radical prostatectomy in 43 cases, TUR in 4, and open prostatectomy in another 4. Duration of incontinence ranged from 1 to 10 yr with an average of 3.5 yr.
  
  
  RESULTS
  All patients but 5 were regulated during the early postoperative period; 44 patients (including all 5 not regulated during the early period) required a second regulation under local anaesthesia between 1 to 4 mo after surgery, and 17 other patients required more than one delayed regulation. After that, 33 patients (64.7%) were considered cured (25 of them wore no pads at all, and 8 used small pads or sanitary napkins for security but normally remained dry); another 10 cases showed important improvement (19.6%); and only 8 patients remain unchanged (15.7%). The average follow-up time was 32 mo (range: 16-50). The mesh was removed in 1 case owing to urethral erosion and the varitensor in 2 cases owing to infection. There were five (9.8%) uneventful intraoperative bladder perforations at the postoperative period, and there were three mild perineal haematomas (5.9%). Most patients felt perineal discomfort or pain, which was easily treated with oral medications.
  
  
  CONCLUSIONS
  The MRS((R)) allowed postoperative readjustment of the suburethral sling pressure at the immediate or midterm postoperative period, which allowed the achievement of good midterm results in almost 85% of patients without significant postoperative complications.
authors.affiliation: Hospital Comarcal de Monforte, Monforte (Lugo), Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Sousa-Escandón
authors.forename: Javier
authors.initials: J
authors.lastname: Cabrera
authors.forename: Franco
authors.initials: F
authors.lastname: Mantovani
authors.forename: Marco
authors.initials: M
authors.lastname: Moretti
authors.forename: Evangelos
authors.initials: E
authors.lastname: Ioanidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kondelidis
authors.forename: Joerg
authors.initials: J
authors.lastname: Neymeyer
authors.forename: Rui
authors.initials: R
authors.lastname: Noguera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005060:Europe; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology; D013521:Urologic Surgical Procedures, Male / Q000379:methods*