Manikandan Ramaswamy, Kujawa Magda, Pearson Evelyn, O'Reilly Patrick H, Brown Stephen C W
Department of Urology, Stepping Hill Hospital, Stockport, UK.
Int J Urol. 2004 Apr;11(4):206-12. doi: 10.1111/j.1442-2042.2003.00779.x.
To evaluate the results of the tension-free vaginal tape procedure (TVT) from a patient's perspective.
Between May 1999 and January 2002, 90 patients underwent a TVT for genuine stress incontinence (GSI) and mixed incontinence. Prior to the procedure, GSI was confirmed by clinical examination and urodynamic studies. Results were then audited from patient notes and the same patients were sent questionnaires to examine results from a patient perspective.
Overall response rate to the questionnaire was 70 (77%). The mean age of the patients was 50.4 years (range 31-83 years). Sixty-one patients had spinal anesthesia, seven had general anesthesia and two had local anesthesia. Mean hospital stay was 3.36 days (range 2-14 days) and mean period from the operation to the time of the survey and audit was 16.34 months (range 3-28; SD 6.92). Thirty-nine (56%) of the 70 patients who answered said that the operation had cured their incontinence, 16 (23%) had an improvement in their symptoms, 7 (10%) had worsening of their symptoms and 8 (11%) felt that the operation did not make any difference. The overall success rate according to the patients' perspective was 79%, whereas our audit showed an overall success rate of 86% (77% and 82%, respectively, when we compared only the 66 patients who had both notes and replies available for analysis).
Although a patient's perception regarding the success of TVT tends to differ from that of a clinician, it was not found to be statistically significant (P = 0.22, McNemar test). The TVT is a very successful operation, but realistic cure rates should be offered to patients.
从患者角度评估无张力阴道吊带术（TVT）的效果。
1999年5月至2002年1月期间，90例患者因真性压力性尿失禁（GSI）和混合性尿失禁接受了TVT手术。手术前，通过临床检查和尿动力学研究确诊为GSI。然后从患者病历中审核结果，并向相同患者发送问卷，从患者角度检查结果。
问卷的总体回复率为70例（77%）。患者的平均年龄为50.4岁（范围31 - 83岁）。61例患者接受了脊髓麻醉，7例接受了全身麻醉，2例接受了局部麻醉。平均住院时间为3.36天（范围2 - 14天），从手术到调查和审核的平均时间为16.34个月（范围3 - 28；标准差6.92）。在回答问卷的70例患者中，39例（56%）表示手术治愈了他们的尿失禁，16例（23%）症状有所改善，7例（10%）症状恶化，8例（11%）认为手术没有任何效果。从患者角度看总体成功率为79%，而我们的审核显示总体成功率为86%（当我们仅比较有病历和回复可供分析的66例患者时，分别为77%和82%）。
尽管患者对TVT手术成功的认知往往与临床医生不同，但未发现具有统计学意义（P = 0.22，McNemar检验）。TVT是一种非常成功的手术，但应向患者提供实际的治愈率。
