The first and only 522 study to compare a single incision sling to full-length retropubic and transobturator slings

June 28 2020 by Coloplast Interventional Urology
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Indications

The Altis Single Incision Sling Systems are indicated for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD).

Contraindications

Altis slings should not be used in pregnant women, or in women planning future pregnancies or any patient with potential for future growth. Altis slings should not be used in those who are taking anticoagulant therapy, who have an abnormal urethra, who have an intra-operative urethral injury, are immunocompromised, who have a sensitivity to polypropylene, have a pre-existing local or systemic infection, who are immunocompromised, or women that have a known or suspected pathology which would compromise implant or implant placement.

Warnings and Precautions

It is the responsibility of the surgeon to advise the prospective patients or their representatives, prior to surgery, of the possible warnings and precautions associated with the use of this product and the associated surgical risks. The Altis Sling Systems should only be used by surgeons familiar with the surgical procedures and techniques involving transvaginal placement of non-absorbable meshes and who have adequate education and experience in the treatment of female SUI.  Based on physician experience and education, a thorough assessment of each patient should be made to determine the suitability of a synthetic mesh procedure. The patient should be counseled that alternative non-mesh incontinence surgeries may be appropriate, and the reason for choosing a mesh procedure should be explained. Physician should obtain patient consent prior to surgery and ensure that the patient has an understanding of the postoperative risks and potential complications of transvaginal mesh surgery. Patient counseling should include a discussion that the mesh to be implanted is a permanent implant, and that some complications associated with the implanted mesh may require additional surgery; repeat surgery may not resolve these complications. Serious adverse tissue responses or infection may require removal of mesh.

Adverse Effects

Potential adverse events are those associated with surgery using implantable synthetic mesh materials. As with all foreign bodies, the Altis sling is likely to exacerbate any existing infection. Local irritation at the wound site and/or a foreign body response may occur. The following complications are known to occur with synthetic mesh implantation: mesh erosion (e.g., vaginal, bladder), mesh extrusion, mesh exposure, infection, pain (acute or chronic), and bladder, bowel, urethra, vagina, vessel, and/or nerve perforation/injury.  There is also the risk of complete failure of the procedure resulting in continued incontinence due to incomplete support or overactive bladder. The occurrence of these events may require partial or complete removal of the sling. Patients should be monitored regularly after the device has been implanted for immediate treatment of any adverse reaction.

See the device instructions for use for detailed information regarding the implant procedure, warnings /precautions, adverse reactions, prior to using this product.

Coloplast Interventional Urology
The author
Altis® Single Incision Sling Compared to Full-Length Retropubic and Transobturator Slings - 12 months report Erickson T, Roovers JP, Gheiler E, Parekh M, Parva MM, Hanson C, McCrery R, Tu LM. A multi-center prospective study evaluating efficacy and safety of a single-incision sling procedure for stress urinary incontinence. J Minim Invasive Gynecol. 2020 Apr 19. pii: S1553-4650(20)30189-8.
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