Investig Clin Urol.  2019 Nov;60(6):488-495. 10.4111/icu.2019.60.6.488.

Readjustable midurethral sling (REMEEX system) in obese women

• Kim WB
• Lee SW
• Lee KW
• Kim JM
• Kim YH
• Kim ME

• KMID: 2461061
• DOI: http://doi.org/10.4111/icu.2019.60.6.488

Abstract

PURPOSE
To evaluate the success rate and patient satisfaction with the readjustable midurethral sling (REMEEX system) for the treatment of stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) or recurrent SUI in obese and non-obese women.
MATERIALS AND METHODS
Between August 2009 and August 2015, 70 patients who treated with the REMEEX system were stratified into normal, overweight and obesity groups according to body mass index. Objective surgical outcomes were evaluated using a 1-hour pad test that was performed 3 months after surgery. The subjective outcomes and degree of patient satisfaction were evaluated 3 months and 1 year after surgery.
RESULTS
Twenty-six normal weight, 31 overweight, and 13 obese women were included in the study. The objective cure rate determined using the 1-hour pad test revealed that 11 women (42.3%) were cured and 15 (57.7%) had improved in the normal weight group, respectively, compared with 16 (51.6%) and 15 (48.4%) in the overweight group and 6 (46.2%) and 7 (53.8%) in the obese group, respectively (p=0.78). One year after surgery, the subjective success rate was 91.5% in the normal weight group, 93.5% in the overweight group and 92.3% in the obese group. A total of 84.7%, 77.4%, and 77.0% of normal weight, overweight and obese women were very satisfied or satisfied 1 year after surgery, respectively. All groups showed similar success rates and satisfaction.
CONCLUSIONS
The REMEEX procedure is equally effective in obese and normal weight women with ISD-type SUI or recurrent SUI.

Keyword

Obesity; Suburethral slings; Urinary incontinence

MeSH Terms

Body Mass Index
Female
Humans
Obesity
Overweight
Patient Satisfaction
Suburethral Slings*
Urinary Incontinence

Figure

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  Fig. 1 (A) Make an incision in the anterior vaginal wall at the mid-urethral level. (B) Insert the two needles through the vaginal incision until reaching the abdominal site. (C) Check the bladder integrity by means of a cystoscopy. (D) Connect the traction threads to the needles. Images from Neomedic International.

• 

  Fig. 2 Traction threads were implanted in the abdominal site through the anterior vaginal wall at the midurethral level (sagittal view). Images from Neomedic International.

• 

  Fig. 3 (A) Passing traction threads through lateral holes of the varitensor. (B) Turning of the varitensor clockwise so it rests tension free on the fascia of rectus abdominis muscles. (C) Adjusting the device by turning the manipulator. (D) Manipulator disconnector. Images from Neomedic International.

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