Ajust single incision transobturator sling procedure for stress urinary incontinence: results after 1-year follow-up

作者：Cornu Jean Nicolas^*; Peyrat Laurence; Skurnik Ariela; Ciofu Calin; Lucente Vincent R; Haab Francois

来源：International Urogynecology Journal and Pelvic Floor Dysfunction, 2012, 23(9): 1265-1270.

DOI：10.1007/s00192-012-1740-0

• Stress urinary incontinence
• Outpatient
• Mini-invasive
• Single incision sling
• Prospective evaluation

Data on the Ajust (TM), 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.
This prospective evaluation involved 95 consecutive patients implanted with Ajust(TM) 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.
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.
The Ajust(TM) single incision transobturator sling is a safe and effective procedure, with durable results after 1 year.

• 出版日期2012-9