title: Mid- to long-term results of the Remeex system for the treatment of female incontinence due to intrinsic sphincter deficiency: A retrospective analysis of the first 50 patients.
abstract: To retrospectively report our mid- to long-term results following suburethral tension adjustable sling (Remeex system) implantation for stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD).
  
  
  
  Fifty female patients with severe SUI due to ISD underwent Remeex system positioning between May 2002 and March 2013 (mean follow-up 83.8 months, median follow-up 85.4 months). Before surgery, patients were evaluated by physical examination, translabial ultrasonography, cystoscopy, urodynamics, 1 hr pad test and compilation of quality-of-life questionnaire. Postoperatively, based on the physical examination and pad test, patients were stratified into three groups: (i) Cured: perfectly dry patients at stress test, pad weight 0-1 g; (ii) Improved: patients with mild to moderate incontinence, pad weight 2-50 g; and (iii) Failed: unchanged or worsened patients, pad weight >50 g.
  
  
  
  At 7-years mean follow-up, 45 (90.0%) patients were cured, three (6.0%) were improved, and two (4.0%) had failed. Concerning the mean total score of the quality-of-life questionnaire, it increased significantly up to 87.1 ± 5.9 with an improvement of 76.9%. Sling tension readjustment was needed in three patients (6%). The incontinence-free survival curve showed that, after sling positioning and tension readjustments, all the cured patients remained continent during all the follow-up. Complications were represented by bacterial cystitis (6%), de novo urgency (10%), persistent urinary retention (6%), and seroma formation (2%).
  
  
  
  Our 7-year results showed the efficacy of the Remeex procedure in the treatment of SUI due to ISD. These outcomes tended to be confirmed in the mid- to long-term follow-up which would highlight the durability of this technique. Neurourol. Urodynam. 36:770-773, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, San Paolo Hospital, Savona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Giberti
authors.affiliation: Department of Urology, San Paolo Hospital, Savona, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Gallo
authors.affiliation: Department of Urology, San Paolo Hospital, Savona, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Cortese
authors.affiliation: Department of Urology, San Paolo Hospital, Savona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Visalli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D013520:Urologic Surgical Procedures
keywords: stress urinary incontinence; suburethral slings; therapeutics