Long-term outcomes of the Ajust Adjustable Single-Incision Sling for the treatment of stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the effectiveness and overall safety of the Ajust Adjustable Single-Incision Sling in the treatment of female stress urinary incontinence. METHODS: This was a prospective, multicenter study conducted in women diagnosed with stress urinary incontinence. The Ajust Sling was implanted and patients were followed postoperatively for up to 29 months. Evaluations were performed to assess postoperative rate of continence, complications, and patient quality of life (QOL). RESULTS: From November 2008 through May 2009, 52 patients were enrolled and underwent a procedure to implant the Ajust Sling. Overall, 86.3 % of the patients who successfully received the Ajust Sling demonstrated total restoration or improvement of continence at the last study visit. QOL scores related to global bladder feeling and lifestyle improved. Only one patient reported the occurrence of mild pain which resolved without treatment or sequelae. CONCLUSIONS: In long-term follow-up, the Ajust Sling was safe and effective, restoring or improving continence in 86.3 % of patients.

Comparison of retropubic and outside-in transoburator sling systems for the cure of female genuine stress urinary incontinence.

OBJECTIVES: Retropubic tension-free slings are a well established procedure in the treatment of SUI. There were and still are relevant complications and side effects. The transobturator approach is said to be safer and equally effective. This paper compares our data of the first TVT- and TOT-procedures to share our experience. METHODS: In this study (from May 1998 to November 1999 for TVT and from February 2003 to September 2003 for TOT) only patients (n=220 in each group) with genuine SUI due to urethral hypermobility and/or intrinsic sphincter deficiency not showing signs of vaginal prolapse were evaluated. The results of pre- and postoperatively conducted examinations, quality-of-life assessments and urodynamic studies are reported. RESULTS: TOT is equally effective with less intraoperative and postoperative complications (including induction of urge). The procedure is faster and does not necessarily need intraoperative cystoscopy (even though cystoscopy adds to the procedure's safety)--it is thereby cheaper. CONCLUSIONS: performed under the right indication the transobturator approach seems to be preferable when a low-tension midurethral sling procedure is the method of choice.