open access

Vol 88, No 8 (2017)
Research paper
Published online: 2017-08-31
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Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

Tomasz Kluz, Edyta Wlaźlak, Andrzej Wróbel, Wiktor Wlaźlak, Michał Pazdrak, Grzegorz Surkont
DOI: 10.5603/GP.a2017.0076
·
Pubmed: 28930367
·
Ginekol Pol 2017;88(8):407-413.

open access

Vol 88, No 8 (2017)
ORIGINAL PAPERS Gynecology
Published online: 2017-08-31

Abstract

Objective: The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling — Ajust™.

Material and methods: One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location. PFS-TV was performed under standardized conditions at rest and during maximum Valsalva maneuver.

Results: This is a retrospective analysis of data from a total of 31 patients who attended a control visit between the 36th and the 50th month following the operation. Sixteen patients (51.6%) were cured. There were statistically significant differences in urethral mobility (p < 0.0007) and tape-urethra distance (p < 0.002) between cured and not-cured group. The difference in urethral length was not statistically significant. 77.8% of women with a hypermobile urethra was cured in contrast to 15.4% with a normobile urethra. Neither of the groups had a hypomobile urethra patient. There were no significant complications intra- or post-operatively. De novo urgency was observed in 1 patient only.

Conclusions: Implantation of Ajust tape seems to be a safe mode of operative treatment for SUI in women. Our mid-term results suggest that long term effects might be worse compared to retropubic or transobturator tapes, especially at first operative experience with Ajust. Urethral mobility seems to be an important risk factor for treatment failure after Ajust implantation. It seems that patients that may benefit from Ajust most are women with urethral hypomobility but this needs to be verified with a prospective study.

Abstract

Objective: The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling — Ajust™.

Material and methods: One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location. PFS-TV was performed under standardized conditions at rest and during maximum Valsalva maneuver.

Results: This is a retrospective analysis of data from a total of 31 patients who attended a control visit between the 36th and the 50th month following the operation. Sixteen patients (51.6%) were cured. There were statistically significant differences in urethral mobility (p < 0.0007) and tape-urethra distance (p < 0.002) between cured and not-cured group. The difference in urethral length was not statistically significant. 77.8% of women with a hypermobile urethra was cured in contrast to 15.4% with a normobile urethra. Neither of the groups had a hypomobile urethra patient. There were no significant complications intra- or post-operatively. De novo urgency was observed in 1 patient only.

Conclusions: Implantation of Ajust tape seems to be a safe mode of operative treatment for SUI in women. Our mid-term results suggest that long term effects might be worse compared to retropubic or transobturator tapes, especially at first operative experience with Ajust. Urethral mobility seems to be an important risk factor for treatment failure after Ajust implantation. It seems that patients that may benefit from Ajust most are women with urethral hypomobility but this needs to be verified with a prospective study.

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Keywords

stress urinary incontinence, mini-sling, suburethral sling, pelvic floor ultrasound, PFS-TV, transvaginal probe

About this article
Title

Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

Journal

Ginekologia Polska

Issue

Vol 88, No 8 (2017)

Article type

Research paper

Pages

407-413

Published online

2017-08-31

DOI

10.5603/GP.a2017.0076

Pubmed

28930367

Bibliographic record

Ginekol Pol 2017;88(8):407-413.

Keywords

stress urinary incontinence
mini-sling
suburethral sling
pelvic floor ultrasound
PFS-TV
transvaginal probe

Authors

Tomasz Kluz
Edyta Wlaźlak
Andrzej Wróbel
Wiktor Wlaźlak
Michał Pazdrak
Grzegorz Surkont

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