Background/Objectives: Female stress urinary incontinence (SUI) surgical treatment has changed since its beginning. Selecting materials that promote constructive tissue remodelling helps to maintain continence after surgery and minimizes complications. To analyze the long-term urinary continence results in women who underwent SUI surgical correction using the transobturator mid-urethral sling KIM system® (Knotless Incontinence Mesh) and analyze the complications associated with this SUI treatment. Materials and Methods: Prospective study of the first 1000 patients undergoing SUI surgery with the Contasure KIM® sling between April 2007 and December 2018. Results and complications were recorded. Group A represented 94.2% of the sample and were the continent patients after surgery (GA = 942), while Group B accounted for incontinent patients after surgery (5.8%) (GB = 58). Results: The mean age at operation was 60 years. Eutocic deliveries (p = 0.0022), high blood pressure (p = 0.0190), anxiety (p = 0.0084), hemorrhoidectomies (p = 0.0016) and hysterectomies (p = 0.0002) were higher in GB. No differences between groups were found regarding body mass index (GA 26.50; GB 26.93) (p = 0.220649), food or drug allergies (p = 0.0.6547), dystocia (p = 0.2365), diabetes mellitus (p = 0.1715), pelvic surgery (p = 0.8842), other surgery (p = 0.8801) or concomitant treatments that would have an impact on bladder function. Correction of SUI was achieved in 94.2% of cases. Continence persisted over time in 97.98% of continent patients at 4-year follow-up and 90.90% of patients at last follow-up. Mesh caused erosion of the urethra in 0.3% of patients and extruded to the vagina in 0.42%. De novo urinary urgency (2.8%), significant chronic pain (3.6%) and urinary tract infections (3.0%) after surgery were lower than complications reported in reviewed publications. Pain was treated with medication, and all patients were pain-free at the one-year follow-up visit. Conclusions: The mid-urethral transobturator sling KIM system® has good initial and long-term results in patients with stress urinary incontinence, with a low recurrence rate and minimal complications.
Journal of clinical medicine. 2024 Sep 26*** epublish ***
María-Fernanda Lorenzo-Gómez, Javier-Antonio Flores-Carvajal, Magaly-Teresa Márquez-Sánchez, Gerardo-Alfonso Márquez-Sánchez, Javier Flores-Fraile, Filipa-María Alves-Rodrigues, Jose-Antonio Miron-Canelo, Bárbara Yolanda Padilla-Fernández
Department of Surgery, University of Salamanca, 37007 Salamanca, Spain., Group GRUMUR (Urology Multidisciplinary Research Group), IBSAL (Institute for Biomedical Research of Salamanca), 37007 Salamanca, Spain., Urology Section, Department of Surgery, University La Laguna, 38200 Tenerife, Spain.