Paick Jae-Seung, Ku Ja Hyeon, Shin Jae Wook, Park Kwanjin, Son Hwancheol, Oh Seung-June, Kim Soo Woong
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Neurourol Urodyn. 2005;24(1):39-43. doi: 10.1002/nau.20078.
The aim of this study was to determine whether the objective incontinence severity, as measured by the pad test, correlated with urethral parameters, and if the objective incontinence severity was differentiated by the incontinence types and also, if it influenced the patient's clinical outcome.
Two hundred seventy-four female patients who had undergone a tension-free vaginal tape procedure between March 1999 and May 2003 were retrospectively reviewed. The 1 hr pad test was carried out as recommended by the International Continence Society, with some modification. The mean patient age was 55.1 years (range: 28-80). Two hundred-one women (73.3%) that complained of stress urinary incontinence and another 73 women (26.7%) that had additional symptoms of urge incontinence were enrolled as study subjects. A cure for incontinence, after the tension-free vaginal tape procedure, was defined as the absence of a subjective complaint of leakage and the absence of objective leakage on stress testing, and all other cases were considered failures.
In linear regression analysis, the Valsalva leak point pressure (VLPP) was the only explanatory variable influencing the objective incontinence severity. The urine leakage was significant higher in the mixed urinary incontinence group than in the stress urinary incontinence group (39.7 +/- 7.5 g vs. 30.3 +/- 2.8 g, P < 0.05). For the total patients, the failure group had a more severe preoperative objective severity than the cure group (53.2 +/- 16.6 vs. 32.0 +/- 3.0, P < 0.05). Upon a subgroup analysis, a similar result was found in the stress urinary incontinence group (87.1 +/- 8.2 vs. 29.8 +/- 2.8, P < 0.05) but not in the mixed urinary incontinence group.
Our findings suggest that the amount of urine leakage as measured during the pad test may be associated with the clinical outcome, after the anti-incontinence surgery.
本研究旨在确定通过护垫试验测量的客观尿失禁严重程度是否与尿道参数相关，客观尿失禁严重程度是否因尿失禁类型而异，以及它是否会影响患者的临床结局。
回顾性分析了1999年3月至2003年5月间接受无张力阴道吊带手术的274例女性患者。按照国际尿失禁学会的建议并稍作修改进行了1小时护垫试验。患者平均年龄为55.1岁（范围：28 - 80岁）。201名主诉压力性尿失禁的女性（73.3%）和另外73名有急迫性尿失禁附加症状的女性（26.7%）被纳入研究对象。无张力阴道吊带手术后尿失禁的治愈定义为主观上无漏尿主诉且压力测试时无客观漏尿，所有其他情况均视为失败。
在线性回归分析中，瓦尔萨尔瓦漏尿点压力（VLPP）是影响客观尿失禁严重程度的唯一解释变量。混合性尿失禁组的尿液漏出量显著高于压力性尿失禁组（39.7±7.5克对30.3±2.8克，P<0.05）。对于所有患者，失败组术前的客观严重程度比治愈组更严重（53.2±16.6对32.0±3.0，P<0.05）。在亚组分析中，压力性尿失禁组也发现了类似结果（87.1±8.2对29.8±2.8，P<0.05），但混合性尿失禁组未发现。
我们的研究结果表明，护垫试验期间测量的尿液漏出量可能与抗尿失禁手术后的临床结局相关。
