Severe complications and failures of XXXX surgery using the Remeex(  ) adjustable tension sling (external mechanical regulator).

@entity1 @entity322 @entity1494 @entity548
OBJECTIVES: Since 1999, we have performed implantations of Remeex   adjustable prosthetics as rescue treatment for complex or persistent stress @entity322 (SUI) after failure of other surgical treatments (Burch colposuspension, Marshall-Marchetti-Krantz (MMK) or tension-free transvaginal tape [TVT] until 2003 and transobturator tape [TOT] since 2003). We present the results of our series, which include cases with severe complications. MATERIAL AND METHOD: Retrospective study of @entity1 diagnosed with complex or refractory SUI who underwent Remeex(  ) implantation between October 1999 and December 2013. In 5 cases, we conducted cystocele correction in the same operation as the placement of the Remeex(  ). RESULTS: Sixty @entity1 , with a mean age of 66.87 years (range 39-85), underwent operations. The procedure was successful in 68.33% of the cases. The failures consisted of the following: 10% of the @entity1 had mixed @entity322 ( @entity322 ) with @entity1494 ; 8.33% had mild SUI; and 13.33% had urgency urination without @entity322 . Thirty-five percent required adjustments. We recorded 3 cases with severe complications: disabling severe @entity322 in a @entity1 who underwent multiple operations, massive @entity548 in a @entity1 undergoing standard antiplatelet therapy and infected vaginal calculi measuring 7cm on an extruding Remeex thread in a paraplegic @entity1 4 years after the implantation. CONCLUSIONS: Remeex(  ) is an effective and safe procedure for achieving continence in cases of complex or refractory SUI, although it is not exempt from severe complications. Following rigorous protocols can help detect complications and treat them in a timely manner.
