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      Remeex ® System Effectiveness in Male Patients with Stress Urinary Incontinence

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          Abstract

          Background: When conservative management fails, patients with stress urinary incontinence (SUI) are considered for surgical treatment. Simpler, more economical and less invasive surgical techniques, such as the Remeex ® system, have been developed. Objectives: To analyze the objective effectiveness of the Remeex ® system in the treatment of male stress urinary incontinence. To study survival and complication rates of the Remeex ® system in male SUI patients. Materials and methods: Prospective observational study between July 2015 and May 2020. Group A ( n = 7; GA) patients with mild SUI. Group B ( n = 22; GB) patients with moderate SUI. Group C ( n = 18; GC) patients with severe SUI. Effectiveness was assessed by the number of patients achieving complete and partial dryness. Complete dryness was defined as patients using 0–1 safety pads per day; partial dryness as a >50% reduction in the number of pads used. Results were analyzed using descriptive statistics, Student’s t-test. Chi2, Fisher’s exact test, ANOVA, and multivariate analysis. Significance was set at p < 0.05. Results: Mean age 69.76 years, mean follow-up 33.52 months. Objective effectiveness was observed in 89.36% of patients with incontinence. The effectiveness was 85.71% in GA, 90.91% in GB and 88.89% in GC. There were no significant differences among groups ( p = 1.0000). 34.04% of patients with an implant required at least one readjustment, while 66.00% did not require any. There were no significant differences among groups ( p = 0.113) Chi2 = 4.352. 95.74% of implants remained in place by the end of follow-up. We observed complications in 17.02% of patients. Conclusions: Remeex ® system is an effective and safe method for male stress urinary incontinence treatment, regardless of the severity of the incontinence, with high survival and low complication and removal rates. System readjustments are required in one-third of the cases.

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          Most cited references16

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          Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence.

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            Adjustable suburethral sling (male remeex system) in the treatment of male stress urinary incontinence: a multicentric European study.

            To evaluate the effectiveness of a readjustable sling for the treatment of male stress urinary incontinence (SUI). Between October 2002 and August 2005, 51 male patients with mild to severe SUI were prospectively operated with the use of a readjustable sling (MRS) at seven different European hospitals: Spain (2), Italy (2), Greece (1), Germany (1), and Portugal (1). The origin of incontinence was radical prostatectomy in 43 cases, TUR in 4, and open prostatectomy in another 4. Duration of incontinence ranged from 1 to 10 yr with an average of 3.5 yr. All patients but 5 were regulated during the early postoperative period; 44 patients (including all 5 not regulated during the early period) required a second regulation under local anaesthesia between 1 to 4 mo after surgery, and 17 other patients required more than one delayed regulation. After that, 33 patients (64.7%) were considered cured (25 of them wore no pads at all, and 8 used small pads or sanitary napkins for security but normally remained dry); another 10 cases showed important improvement (19.6%); and only 8 patients remain unchanged (15.7%). The average follow-up time was 32 mo (range: 16-50). The mesh was removed in 1 case owing to urethral erosion and the varitensor in 2 cases owing to infection. There were five (9.8%) uneventful intraoperative bladder perforations at the postoperative period, and there were three mild perineal haematomas (5.9%). Most patients felt perineal discomfort or pain, which was easily treated with oral medications. The MRS((R)) allowed postoperative readjustment of the suburethral sling pressure at the immediate or midterm postoperative period, which allowed the achievement of good midterm results in almost 85% of patients without significant postoperative complications.
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              The standardisation of terminology of lower urinary tract function. The International Continence Society Committee on Standardisation of Terminology.

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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                14 May 2021
                May 2021
                : 10
                : 10
                : 2121
                Affiliations
                [1 ]Department of Surgery, University of Salamanca, 37007 Salamanca, Spain; gamarquezs@ 123456gmail.com (G.-A.M.-S.); sebasv_2000@ 123456hotmail.com (S.V.-M.); mflorenzogo@ 123456yahoo.es (M.-F.L.-G.)
                [2 ]Section of Urology, Department of Surgery, University of La Laguna, 38200 Tenerife, Spain; padillaf83@ 123456hotmail.com
                [3 ]Department of Urology, University Hospital Arnau de Villanova, 46015 Valencia, Spain; mperanurologo@ 123456gmail.com
                [4 ]Department of Urology, University Hospital Casa de Salud, Catholic University of Valencia, 46021 Valencia, Spain; pedronavalon@ 123456yahoo.com
                [5 ]Renal Urological Multidisciplinary Research Group (GRUMUR), Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; magalymarquez77@ 123456gmail.com
                [6 ]Department of Urology, University Hospital of Ávila, 05004 Ávila, Spain
                [7 ]Department of Urology University Hospital of Salamanca, 37007 Salamanca, Spain
                Author notes
                [* ]Correspondence: j.flores@ 123456usal.es
                Author information
                https://orcid.org/0000-0003-2189-4691
                https://orcid.org/0000-0002-8566-6033
                https://orcid.org/0000-0002-2797-3262
                https://orcid.org/0000-0003-1046-0118
                https://orcid.org/0000-0003-1338-0551
                https://orcid.org/0000-0003-1208-3408
                Article
                jcm-10-02121
                10.3390/jcm10102121
                8156339
                34068891
                6eae36cd-2cfb-4fa7-b209-c962af235896
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 10 April 2021
                : 12 May 2021
                Categories
                Article

                male stress urinary incontinence,remeex® system,slings,effectiveness

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