title: Ajust single incision transobturator sling procedure for stress urinary incontinence: results after 1-year follow-up.
abstract: OBJECTIVE
  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 Ajust 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 Ajust single incision transobturator sling is a safe and effective procedure, with durable results after 1 year.
authors.affiliation: Department of Urology, Groupe Hospitalo-Universitaire EST, Assistance Publique-Hôpitaux de Paris, University Paris VI, Tenon Hospital, Paris, France. jeannicolas.cornu@gmail.com
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Cornu
authors.forename: Laurence
authors.initials: L
authors.lastname: Peyrat
authors.forename: Ariela
authors.initials: A
authors.lastname: Skurnik
authors.forename: Calin
authors.initials: C
authors.lastname: Ciofu
authors.forename: Vincent R
authors.initials: VR
authors.lastname: Lucente
authors.forename: Francois
authors.initials: F
authors.lastname: Haab
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D057566:Self Report; D018709:Statistics, Nonparametric; D053825:Suburethral Slings / Q000009:adverse effects; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000150:complications; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*