Altis® 522 Trial - Treatment of Female Stress Urinary Incontinence

This study is a prospective, post-market, multi-center, cohort assessment comparing Altis SIS
(n=178) and transobturator and/or retropubic slings (n=178) in the treatment of stress
urinary incontinence at up to 40 U.S. and international sites. Subjects will be followed for
a total of 36 months with scheduled visits at 6, 12, 18, 24 and 36 months. The study
population will consist of adult female subjects with stress incontinence who are clinically
indicated for surgical intervention with a mesh sling.

Inclusion Criteria:

- The subject is female and at least 18 years of age.

- The subject is able and willing to complete all procedures and follow-up visits
indicated in this protocol.

- The subject has confirmed stress urinary incontinence through cough stress test or
urodynamics.

- The subject has failed two non-invasive incontinence therapies (such as Kegal
exercise, behavior modification, pad use, biofeedback, etc.) for > 6 months.

Exclusion Criteria:

- The subject has an active urogenital infection or active skin infection in region of
surgery.

- The subject has confirmed Pelvic Organ Prolapse (POP) of Stage 2 or higher as
determined by POP-Q prolapse grading.

- The subject is having a concomitant pelvic floor procedure.

- The subject has incontinence due to neurological causes (e.g. multiple sclerosis,
spinal cord/brain injury, cerebrovascular accident, detrusor-external sphincter
dyssynergia, Parkinsons disease, or similar conditions).

- The subject had a prior surgical stress urinary incontinence treatment.

- The subject has undergone radiation or brachy therapy to treat pelvic cancer.

- The subject has urge predominant incontinence by MESA assessment.

- The subject has an atonic bladder or post void residual (PVR) above 100 cc on ≥ 2
occasions.

- The subject is pregnant and/or is planning to get pregnant in the future.

- The subject has a contraindication to the surgical procedure of the product
Instructions for use (IFU).

- The subject is enrolled in a concurrent clinical trial of any treatment (drug or
device) that could affect continence function, without the sponsors approval.