摘要
目的探讨盆腔器官脱垂(POP)重建术后压力性尿失禁(SUI)加重或新发的影响因素。方法回顾性分析2008年1月至2017年12月因POP分期Ⅱ~Ⅳ期于北京大学第一医院行盆底重建手术并完成随访的613例患者的临床资料。根据POP患者术前、术后SUI的发生情况,分为术后SUI症状缓解组(270例)和进展组(99例)。采用多因素logistic回归分析术后SUI症状加重或新发的独立危险因素。结果 613例患者中,术前存在显性SUI症状314例(51.22%,314/613),其中192例(61.15%,192/314)术后症状消失,122例(38.85%,122/314)术后仍存在SUI症状,术后新发SUI 80例(26.76%,80/299);高龄、术前尿动力学检查提示最大尿道闭合压低、隐匿性SUI及尿道梗阻是盆底重建术后SUI加重或新发的独立危险因素(P <0.05);盆底重建手术联合抗尿失禁手术是术后SUI的保护因素(P <0.05)。结论对于存在术后SUI加重或新发高危因素的POP患者,术前应综合评估,制定合理的手术方案,必要时同时行抗尿失禁手术。
Objective To investigate the risk factors of aggravated or de novo stress urinary incontinence(SUI) after pelvic floor repair surgery in pelvic organ prolapse(POP) patients. Methods The clinical data of 613 patients were retrospectively analyzed, with each of them underwent pelvic floor repair surgery in Peking University First Hospital from January 2008 to December 2017 due to POP-Q stage II~IV and completed the follow-up.Among those patients, 270 patients with SUI cured or improved after operation were classified as remission group;99 patients with SUI aggravated or de novo SUI after operationwere classified as progression group. Multivariate logistic analysis was used to find out the independent risk factors of aggravated or de novo stress urinary incontinence after pelvic floor repair surgery in POP patients. Results 314 cases(314/613, 51.22%) had SUI before operation, of which 192 cases(192/314, 61.15%) were cured after operation and 122 cases(122/314, 38.85%) still had SUI. 80 cases(80/299, 26.76%) had de novo stress urinary incontinence after operation;Advanced age, preoperative maximum urethral closure depression, occulent SUI and urethral obstruction were independent risk factors for aggravated or de novo of SUI after surgery(P < 0.05);Pelvis floor repair surgery combined with anti-urinary incontinence surgery is the protective factor of postoperative SUI(P < 0.05). Conclusions For POP patients with highly risky factors of aggravated or de novo stress urinary incontinence, comprehensive evaluation and reasonable surgical strategy should be taken pre-operation and anti-incontinence surgery should be performed simultaneously when necessary.
作者
王潇潇
陆叶
WANG Xiaoxiao;LU Ye(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China)
出处
《中国妇产科临床杂志》
CSCD
2021年第2期139-142,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
压力性尿失禁
盆底重建手术
新发压力性尿失禁
隐匿性压力性尿失禁
尿动力学
stress urinary incontinence
pelvic floor repair surgery
de novo stress urinary incontinence
occult stress urinary incontinence
urodynamics
