摘要
目的探讨两种尿道中段吊带术治疗女性压力性尿失禁(SUI)的临床疗效、安全性及对患者性功能等生活质量的影响。方法采用多中心大样本回顾性研究方法收集2018年1—12月国内7家泌尿中心共531例女性中、重度SUI患者纳入本研究,其中中部战区总医院78例,上海交通大学医学院附属仁济医院南院122例,上海交通大学附属第一人民医院67例,江苏省人民医院68例,西安交通大学第一附属医院71例,浙江省人民医院65例,厦门大学附属第一医院60例。531例中接受耻骨后尿道中段吊带术(TVT组)214例,平均年龄(58.14±10.16)岁,已绝经181例(84.6%),生育次数≥2次者89例(41.6%),尿失禁问卷表简表(ICI-Q-SF)评分(16.00±1.73)分,中度尿失禁166例(77.6%),重度尿失禁48例(22.4%)。接受两种经闭孔尿道中段吊带术(TOT/TVT-O组)患者317例,平均年龄(58.33±10.25)岁,已绝经247例(77.9%),生育次数≥2次者120例(37.8%),ICI-Q-SF评分(15.79±1.75)分,中度尿失禁256例(80.8%),重度尿失禁61例(19.2%)。两组一般资料各项参数比较差异无统计学意义(P>0.05)。对两组患者术后1、6、12个月ICI-Q-SF、常见并发症及主观尿失禁治愈情况(PGI-I)和满意度进行评估随访。以ICI-Q-SF评分改善>50%(治愈+明显改善)和1 h尿垫试验<10 g(定性指标)作为手术成功率的判断指标。结果两种手术方式术后1个月均有较高的总体有效率(治愈+显效),TVT组为94.9%(203/214),TOT/TVT-O组为93.7%(297/317),两组手术成功率比较差异无统计学意义(P>0.05)。术后尿失禁症状改善程度(治愈率) TVT组[88.3%(189/214)]略高于TOT/TVT-O组[77.0%(244/317)],差异有统计学意义(P<0.05)。术后6、12个月随访尿失禁复发率无变化,TVT组为4.4%(9/203),TOT/TVT-O组为5.4%(16/297),两组比较差异无统计学意义(P>0.05)。术后12个月主观治愈率TVT组为96.3%(206/214),TOT/TVT-O组为95.9%(304/317),两组比较差异无统计学意义(P>0.05)。术后并发症情况,
Objective The clinical efficacy,safety and quality of life in female patients with stress urinary incontinence(SUI)treated by midurethral sling were studied by multicenter retrospective study.Methods From January 2018 to December 2018,531 female patients with severe stress urinary incontinence from seven domestic urinary center were included in this study,including 78 cases from General Hospital of Central Theater Command,122 cases from Shanghai Jiao tong University School of Medicine Affiliated Ren Ji Hospital,67 cases from Shanghai Jiaotong University Affiliated First People’s Hospital,68 cases from People’s Hospital of Jiangsu Province,71 cases from The First Affiliated Hospital of Xi’an Jiaotong University,65 cases from Zhejiang Provincial People’s hospital,60 cases from Xiamen University First Affiliated Hospital.Among the 531 patients,214 cases received TVT sling with an average age of(58.14±10.16)years.181 cases were in postmenopausal(84.6%).The number of births≥2 times was 89(41.6%)cases.The score of ICI-Q-SF was 16.00±1.73.There were 166 cases of moderate incontinence(77.6%)and 48 cases of severe incontinence(22.4%).There were 317 patients in the TOT/TVT-O group with an average age of(58.33±10.25)years.247 cases were in postmenopausal(77.9%).The number of births≥2 times was 120(37.8%)cases.The score of ICI-Q-SF was 15.79±1.75.There were 256 cases of moderate incontinence(80.8%)and 61 cases of severe incontinence(19.2%).There was no statistically significant difference in general data parameters between the two groups(P>0.05).1,6,12 months after the operation,the two groups of patients incontinence questionnaire Summary(ICI-Q-SF),common complications and Patient Global Impression of Improvement(PGI-I),satisfaction evaluation follow-up.ICI-Q-SF score improved>by 50%(cure+significant improvement)and 1-hour pad test<10 g(qualitative index)were used as the evaluation index of surgical success.Result Both of the two surgical methods have high successive rate.There was no significant difference
作者
吕坚伟
刘波
吕婷婷
文伟
孟小鑫
李旭东
徐智慧
陈跃东
潘铁军
Lyu Jianwei;Liu Bo;Lyu Tingting;Wen Wei;Meng Xiaoxin;Li Xudong;Xu Zhihui;Chen Yuedong;Pan Tiejun(Department of Urology,Shanghai Jiaotong University School of Medicine Affiliated Ren Ji Hospital,Shanghai 201112,China;Department of Urology,General Hospital of Central Theater Command,Wuhan 430070,China;Department of Urology,Shanghai Jiaotong University Affiliated First People's Hospital,Shanghai 200080,China;Department of Urology,People′s Hospital of Jiangsu Province,Nanjing 210029,China;Department of Urology,The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Department of Urology,Zhejiang Provincial People′s Hospital,Hangzhou 310014,China;Department of Urology,Xiamen University First Affiliated Hospital,Xiamen 361001,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2020年第5期368-373,共6页
Chinese Journal of Urology
关键词
尿失禁
压力性
经耻骨后尿道中段吊带术
经闭孔尿道中段吊带术
多中心研究
Urinary incontinence
stress
Tension-free vaginal tape(TVT)
Trans-obturator tape/Tension-free vaginal tape-obturatoer(TOT/TVT-O)
Multicenter study
