Hong Bumsik, Park Sungchan, Kim Hong Sik, Choo Myung-soo
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Urol. 2003 Sep;170(3):852-6. doi: 10.1097/01.ju.0000081095.85420.ab.
We performed this study to evaluate factors related to urinary retention after a tension-free vaginal tape (TVT) procedure for female stress urinary incontinence.
We retrospectively analyzed the records of 375 women with a followup of at least 6 months from among patients who underwent the TVT procedure between March 1999 and May 2002 at our institution. We analyzed multiple parameters, including patient characteristics, symptoms and urodynamic studies, using univariate and multivariate regression analyses with respect to postoperative urinary retention, as defined by the need for intermittent catheterization for at least 3 days after the procedure. All patients in the nonretention (343) and retention (32) groups answered a global satisfaction question.
In answer to a global satisfaction question 338 of the 375 patients (90.1%) favored the procedure. Univariate analysis demonstrated that patient mean age, parity, peak urinary flow and a history of hysterectomy predicted urinary retention. However, on multivariate analyses the peak urinary flow rate was the only significant independent predictive factor (p = 0.007). While 28 patients (87.5%) in the retention group regained normal voiding without a specific procedure, 4 required tape release or cutting within 3 month of surgery. The global satisfaction question showed a significant difference between the nonretention and retention groups (91.5% vs 75% satisfaction, p = 0.03).
An accurate measurement of the peak urinary flow rate could predict women at risk for postoperative urinary retention that compromises global satisfaction after the highly curative TVT procedure.
我们开展这项研究以评估与女性压力性尿失禁无张力阴道吊带术（TVT）后尿潴留相关的因素。
我们回顾性分析了1999年3月至2002年5月在我院接受TVT手术患者中375名女性的记录，这些患者至少随访6个月。我们分析了多个参数，包括患者特征、症状和尿动力学研究，采用单因素和多因素回归分析来研究术后尿潴留情况，术后尿潴留定义为术后至少3天需要间歇性导尿。非尿潴留组（343例）和尿潴留组（32例）的所有患者都回答了一个总体满意度问题。
在回答总体满意度问题时，375例患者中有338例（90.1%）对该手术表示满意。单因素分析表明，患者平均年龄、产次、最大尿流率和子宫切除术史可预测尿潴留。然而，多因素分析显示最大尿流率是唯一显著的独立预测因素（p = 0.007）。尿潴留组中有28例患者（87.5%）未经特殊处理恢复了正常排尿，4例在术后3个月内需要松解或切断吊带。总体满意度问题显示非尿潴留组和尿潴留组之间存在显著差异（满意度分别为91.5%和75%，p = 0.03）。
准确测量最大尿流率可预测术后有尿潴留风险的女性，而尿潴留会影响疗效显著的TVT手术后的总体满意度。
