A retrospective, single-centre safety audit of the Altis® single incision sling in the surgical treatment of female stress urinary incontinence

Continence (Amsterdam, Netherlands) Pub Date : 2024-12-18 DOI:10.1016/j.cont.2024.101741

E. Collier , S. Housmans , F. Van der Aa

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引用次数: 0

Abstract

Background:

Single incision slings (SIS) and adjustable single incision slings (ASIS) are the latest generation of midurethral slings (MUS), used for the surgical treatment of female stress urinary incontinence, that seek to minimize the morbidity and complications associated to the conventional retropubic and transobturator midurethral slings. Its use has recently come under scrutiny following concerns about long-term complications.

Aims:

We conducted an internal audit of the short-to-medium term safety and absence of reported complications of the Altis® SIS in our medical centre (University Hospital of Leuven, Belgium). Secondary outcome was treatment efficacy, defined as no self-reported SUI symptoms.

Methods:

A file review of all patients implanted with an Altis® sling at our institution between 2014 and May 2021 was performed. Baseline characteristics and outcomes were reported with the use of descriptive statistics.

Results:

212 women were included in our safety analysis, 192 women in the efficacy analysis. The safety analysis showed 74 complications of any kind. Mesh exposure occurred in 16 women (7.5%) after a mean period of 15 months. Eleven of them (5.2%) underwent excision of the exposed mesh. Arterial haemorrhage requiring embolization, and mesh infection, both occurred once. Dyspareunia for the patient (3.3%) or her partner (1.4%) was encountered in nine cases. Four cases were linked to mesh exposure, of which three underwent partial sling excision. De novo urgency (5.7%) and urge incontinence (7.3%) were reported in 25 women (13%) and were managed with anticholinergic drugs. Regarding efficacy outcomes, 161 women (83.8%) reported no residual urine loss at the first post-operative consultation. Thirteen women (6.7%) had persistent SUI. Eight women (4.2%) underwent reintervention receiving a second sling.

Conclusion:

We can conclude that the short-to-medium term results in our centre align with those reported in existing literature.

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Altis®单切口吊带在女性压力性尿失禁手术治疗中的回顾性、单中心安全性审核

背景：单切口吊带（SIS）和可调节单切口吊带（ASIS）是最新一代的中尿道吊带（MUS），用于女性压力性尿失禁的外科治疗，旨在减少与传统耻骨后和经闭口上尿道吊带相关的发病率和并发症。由于担心长期并发症，它的使用最近受到了严格审查。目的：我们在我们的医疗中心（比利时鲁汶大学医院）对Altis®SIS的中短期安全性和无并发症报告进行了内部审计。次要终点是治疗效果，定义为没有自我报告的SUI症状。方法：对2014年至2021年5月在我院植入Altis®吊带的所有患者进行档案回顾。使用描述性统计报告基线特征和结果。结果：212名妇女被纳入我们的安全性分析，192名妇女被纳入疗效分析。安全性分析显示出现各种并发症74例。16名妇女（7.5%）在平均15个月后出现补片暴露。其中11例（5.2%）切除了暴露的补片。需要栓塞的动脉出血和补片感染均发生一次。9例患者（3.3%）或其伴侣（1.4%）遇到性交困难。4例与网片暴露有关，其中3例接受部分吊带切除。25名女性（13%）报告了新发急症（5.7%）和急迫性尿失禁（7.3%），并使用抗胆碱能药物进行治疗。关于疗效结果，161名女性（83.8%）在第一次术后咨询时报告无残留尿丢失。13例（6.7%）存在持续性SUI。8名妇女（4.2%）接受了第二次吊带的再干预。结论：我们可以得出结论，我们中心的中短期结果与现有文献报道的结果一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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