Effects of the REMEEX System® in Female Patients with Intrinsic Sphincteric Deficiency and Recurrent Urinary Incontinence: 10-Year Outcomes
Dr Hee Chang Jung (1), Dr Pill Hyun Song (1)
(1) Department Of Urology, Yeungnam University Medical Center, Daegu, South Korea
This study was conducted to evaluate the outcomes of the REMEEX systemⓇ (EXternal MEchanical REgulation, Neomedic International, Terrassa (Barcelona), Spain) for treatment of intrinsic sphincteric deficiency (ISD) and recurrent urinary incontinence (UI) in female patients.
From August 2006 to January 2008, a total of 43 patients underwent the REMEEX systemⓇ. Patients were categorized into failed UI (Group A, 16 patients) and ISD (Group B, 27 patients). Of the 43 patients, 16 had previous incontinence surgical interventions, 9 had other pelvic surgeries, 10 either had spine surgery, diabetes mellitus, cerebrovascular accident, Parkinson's disease, spine fracture, herniated lumbar disc, mood disorder or so on. The success rate of patients after surgery was assessed by cure and satisfaction rates postoperatively at follow-up at 1, 3 and 10 years. Clinical, urodynamic, peri and post-operative data with respect to success rates were analyzed.
The mean age of patients was 61.7 years (range 44-81) and mean follow-up period 126.3 months (range, 120-138). Total cure rates with the REMEEX systemⓇ(Group A/Group B) were 100.0/76.2% at 1 year, 90.9/79.0% at 3 years, and 85.4/74.2% at 10 years follow-up. Satisfaction rates were 83.4/71.5% at 1 year, 81.8/68.4%, and 80.4%/64.5% at 10 years follow-up in group A and B. Four patients (10.8%) experienced wound infections. Of these, one patient was treated using intravenous antibiotics and the other had their varitensor removed. Other minimal postoperative complications were immediately resolved.
The REMEEX systemⓇ may be an effective procedure regardless of previous incontinence surgical interventions and ISD. The correct sling tension is easily achieved during the early postoperative period, and when necessary, is able to convert late failures into cures. The problems of recurrent UI during the follow-up period were also resolved successfully in every case.