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

Department of Urology, Groupe Hospitalo-Universitaire EST, Assistance Publique-Hôpitaux de Paris, University Paris VI, Tenon Hospital, Paris, France.
International Urogynecology Journal (Impact Factor: 2.16). 05/2012; 23(9):1265-70. DOI: 10.1007/s00192-012-1740-0
Source: PubMed

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

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    • ". Cornu et al. observed de novo OAB symptoms in 10 patients (10.5% of the sample) [20]. It is worth noting that this rate is comparable with that given for retropubic and transobturator tape implantation. "
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    ABSTRACT: The primary outcome of this study was to evaluate the subjective and objective outcomes of an adjustable Single Incision Sling (Ajust™ C.R. Bard Inc., New Providence, NJ, USA) for the treatment of SUI, with a 2-year follow-up. The secondary outcome was to evaluate the safety of this procedure and the impact of this mini-sling on the filling and voiding phases of the bladder.
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