耻骨后和经闭孔尿道中段悬吊术对不同分型压力性尿失禁疗效的长期随访

doi:10.19723/j.issn.1671-167X.2019.04.017

Abstract

Abstract:

Objective: To evaluate the long-term efficacy of tension-free vaginal tape(TVT)and trans-obturator tape(TOT)for different types of female stress urinary incontinence(FSUI).Methods: The cli-nical data of all female patients with stress urinary incontinence (SUI) who underwent mid-urethral slings (MUS) in Peking University People’s Hospital from January 2008 to June 2016 were retrospectively analyzed,and all the patients were followed up. Based on the level of abdominal leak point pressure (ALPP), the patients with ALPP lower than or equal to 60 cmH₂O (1 cmH₂O=0.74 mmHg) were regarded as intrinsic sphincter deficiency (ISD) type, and the patients with ALPP higher than 60 cmH₂O were regarded as non-ISD type. According to the degree of remission of leakage of urine by using the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF), the surgical outcomes were divided into three categories: cured, improved or failed. The efficacy of TVT and TOT for different types of FSUI was evaluated by comparing the cure rate of TVT with the cure rate of TOT in ISD type and non-ISD type separately.Results: A total of 170 patients were included in this study. The patients were among 30-78 years, and the follow-up period were among 12-110 months. In the study, 117 patients belonged to non-ISD type. Of whom 30 underwent TVT with a cure rate of 86.7% (26/30), and the other 87 underwent TOT with a cure rate of 69.0% (60/87). The cure rate of TVT was higher than that of TOT in non-ISD type, however, Chi-square test showed that there was no significant difference (χ ²=3.589, P>0.05). In addition, 53 patients belonged to ISD type, of whom 16 underwent TVT with a cure rate of 87.5% (14/16), and the other 37 underwent TOT with a cure rate of 51.4% (19/37). The cure rate of TVT was higher than that of TOT in ISD type, and Chi-square test showed that the difference was statistically significant (χ ²=6.212, P<0.05).Conclusion: For the treatment of FSUI, MUS can achieve satisfactory long-term efficacy. For non-ISD type, the cure rates of TVT and TOT are similar, while for ISD type, the cure rate of TVT is higher than that of TOT.

Key words: Stress urinary incontinence, Mid-urethral slings, Intrinsic sphincter deficiency

CLC Number:

R699.7

Xian-hui LIU,Wei-yu ZHANG,Hao HU,Qi WANG,Tao WANG,Yong-xin HE,Ke-xin XU. Long-term follow-up of the efficacy of tension-free vaginal tape and trans-obturator tape for different types of stress urinary incontinence[J].Journal of Peking University(Health Sciences), 2019, 51(4): 694-697.

Figures/Tables 2

Table 1

Preoperative information of patients of different FSUI types"

Items		TVT	TOT	P
Patients, n	ISD	16	37
Patients, n	Non-ISD	30	87
Age/years, $x ?$ ±s	ISD	50.31±9.87	54.83±8.83	0.06
Age/years, $x ?$ ±s	Non-ISD	59.20±10.63	57.35±10.05	0.11
BMI/(kg/m²)	ISD	25.80±4.01	25.51±4.14	0.82
BMI/(kg/m²)	Non-ISD	24.87±2.27	24.87±2.77	0.99
Menopause, n (%)	ISD	8(50.00)	27(72.97)	0.11
Menopause, n (%)	Non-ISD	23(76.67)	62(71.26)	0.57

Table 1

Table 2

References 19

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Long-term follow-up of the efficacy of tension-free vaginal tape and trans-obturator tape for different types of stress urinary incontinence

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MUS	Non-ISD			ISD
MUS	Patients, n	Cure, n (%)	Not cure, n (%)	Patients, n	Cure, n (%)	Not cure, n (%)
TVT	30	26(86.7)	4(13.3)	16	14(87.5)	2(12.5)
TOT	87	60(69.0)^*	27(31.0)	37	19(51.4)^#	18(48.6)

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