Ajust®: Prospective study and 1-year follow-up - A series of 60 female patients

Objectives. - Evaluate functional and anatomical outcomes as welt as complications, 1 year after the implantation of the Ajust (R) sub-urethral adjustable single-incision sling. Study design. - Prospective study on 60 female patients suffering from stress urinary or mixed urinary incontinence with quality of life assessment. Ambulatory surgeries were performed under local anesthesia with or without sedation. Pain was evaluated using the VAS scale. Postoperative follow-up was performed at 2 and 12 months. Results. - Forty-eight patients suffered from stress incontinence only, with one of them suffering from sphincter deficiency, and the remaining 12 suffered from mixed urinary incontinence. Mean surgery time was 7.15 minutes. All patients received a local anesthesia, and 33 were sedated. Per-operative pain level was equal to 31.8/100, and 17/100 upon discharge. A 100 mL per-operative hemorrhage was described. At 2-month follow-up, four de novo urgency, four de novo dysuria, one urinary infection, 11 palpable lateral cords, 12 moderate postoperative pain were described. At 1-year follow-up, two mesh exposures formed, including one expelled anchor for one of them. At 1 year, cure rate, improvement and failure rate were respectively 89.6%, 6.9% and 3.4%. Quality of life indexes were significantly improved. One patient required a new surgery at 2 months, due to initial failure. Conclusions. - The efficacy of this mini-invasive sling, without specific complication, must be compared with the other classic sub-uretral slings. (C) 2013 Published by Elsevier Masson SAS.