Presented by: PHIL HYUN SONG MD.PhD.
Department of Urology, College of Medicine, Yeungnam University

Introduction

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.

Materials

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 14 years. Clinical, urodynamic, peri and post-operative data with respect to success rates were analyzed.

Results

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The mean age of patients was 73.1 years (range 58-81) and mean follow-up period 148.4 months (range, 168-186). 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 81.4/69.4% at 14 years follow-up. Satisfaction rates were 83.4/71.5% at 1 year, 81.8/68.4%, and 75.4%/62.5% at 14 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.

Conclusion

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.

Funding

None

Lead Authors

Yeong Uk Kim, MD.PhD
Department of Urology, College of Medicine, Yeungnam University

Co-Authors

Jae Young Kim, MD.PhD
Department of Urology, College of Medicine, Yeungnam University

Tae-Hwan Kim, MD.PhD.
Department of Urology, School of Medicine, Kyungpook National University

Hee Chang Jung, MD.PhD.
Department of Urology, College of Medicine, Yeungnam University

Kyung-jin Oh, MD.PHD
Chonnam National University Hospital