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

Int Urogynecol J

Department of Urology, Groupe Hospitalo-Universitaire EST, Assistance Publique-Hôpitaux de Paris, University Paris VI, Tenon Hospital, Paris, France.

Published: September 2012

AI Article Synopsis

  • The Ajust procedure for managing female stress urinary incontinence shows promising results, with an 80% success rate after an average follow-up of 21 months.
  • Most patients reported significant improvement, with 79 of 95 experiencing no leakage issues, and only a few complications were noted, manageable with conservative treatment.
  • Overall, the study concludes that the Ajust sling is a safe and effective option for addressing urinary incontinence in women, demonstrating lasting benefits beyond one year.

Article Abstract

Introduction And Hypothesis: Data on the Ajust, 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.

Methods: This prospective evaluation involved 95 consecutive patients implanted with Ajust 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.

Results: 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.

Conclusions: The Ajust single incision transobturator sling is a safe and effective procedure, with durable results after 1 year.

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Source
http://dx.doi.org/10.1007/s00192-012-1740-0DOI Listing

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