Cabestrillo suburetral regulable con prótesis REMEEX ®. Resultados 1999-2004

Abstract

Objetive To analyze our results after several colpourethropexy interventions using a suburethral readjustable sling with the application of the REMEEX ® prosthesis for the treatment of stress urinary incontinence. Material and method We prospectively analyzed all surgical patients treated in our Urogynecology Unit from March 1999 to December 2004. The total number of patients who underwent surgery was 123. The patients were followed-up at 45 days, 3 months, 6 months and 1 year after the intervention. The mean length of follow-up was 35 months. All the patients except five had genital prolapse (surgical grade) associated with urinary incontinence (stress or mixed). The five remaining patients had recurrent stress incontinence after previous unsuccessful techniques (Marshall-Burch). Results The mean age was 60.5 years (CI 95%: 39-87). The mean body mass index was 30.8 (CI 95%: 21.7-41.3). Cystometry was performed in all surgical patients; 69% were classified as having genuine stress incontinence and 31% as having mixed incontinence. The mean operating time was 72 minutes (CI 95%: 40-210), and the mean hospital stay was 6 days (CI 95%: 3-18). Currently, all the patients have a negative stress test. Of these, 93.1% report they feel completely cured, 5.2% find themselves to be much better and 1.7% reported a slight improvement. None of the patients developed postsurgical obstruction or de novo incontinence. Postoperative complications consisted of 18 urinary infections (14.6%) and the remainder were abdominal wound complications: subcutaneous hematomas in 3 patients (2.4%) and surgical wound infection in 13 patients (10.5%). Conclusions We believe that the REMEEX ® system (readjustable suburethral sling) should be the technique of choice in the treatment of stress incontinence (genuine or mixed) associated with genital prolapse.