Is bladder outlet obstruction responsible for a successful surgical outcome in women with complicated stress urinary incontinence? Urodynamic results before and after a Remeex® readjustable sling. Issue 8 (26th August 2021)

• Record Type: Journal Article
• Authors: Mateu Arrom, Laura; Sabiote Rubio, Laia; Palou, Joan; Errando‐Smet, Carlos
• Is Part Of: Neurourology and urodynamics. Volume 40:Issue 8(2021)
• Page Start: 1966
• Page End: 1971
• Publication Date: 2021-08-26
• Subjects: adjustable sling -- complicated stress urinary incontinence -- suburethral sling; Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.24774
• Languages: English
• ISSNs: 0733-2467

Abstract

Abstract: Aims: To describe the changes in urodynamic parameters after Remeex® placement in women with recurrent stress urinary incontinence (rSUI) or intrinsic sphincteric deficiency (ISD) and to analyze a potential relationship between postoperative bladder outlet obstruction and a successful surgical outcome. Methods: Retrospective analysis of those women who had undergone Remeex® placement due to rSUI or ISD in our department between 2000 and 2017. All patients underwent urodynamic evaluation before and after the surgery. If tension readjustment was required, postoperative urodynamics was performed after the last regulation, once the final continence status had been achieved. The female Bladder Outlet Obstruction Index (BOOIf) was calculated for all patients postoperatively. Obstruction was considered present if BOOIf was >18. Pre‐ and postoperative urodynamic variables were compared. Postoperative urodynamic changes were also compared between cured and noncured patients. Results: A total of 205 women were included. After a follow‐up of 89 ± 36 months, 165 women (80.5%) were continent. A significant impairment in the majority of the urodynamic parameters was observed. Mean postoperative BOOIf was −11.8 ± 21.5 in cured patients and −15.3 ± 23.1 in noncured patients ( p = 0.365); 15 (9.1%) patients in the cured group had a postoperative BOOIf >18, whereas all (100%) patients in the noncured group had a postoperative BOOIf <18. Conclusions: Most urodynamic parameters may worsen after the Remeex® system placement. Postoperative urodynamic parameters may not differ substantially between cured and noncured patients, although a certain grade of bladder outlet obstruction could be related to postoperative continence status in some patients.