Gandhi Sanjay, Abramov Yoram, Kwon Christina, Beaumont Jennifer L, Botros Sylvia, Sand Peter K, Goldberg Roger P
North Shore Urogynecology, 351 S. Greenleaf Ave., Suite E, Park City, IL, 60085, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2006 Feb;17(2):125-30. doi: 10.1007/s00192-005-1369-3. Epub 2005 Aug 4.
To compare the subjective and objective cure rates in women who underwent either the SPARC or the TVT midurethral sling for the treatment of stress urinary incontinence. This retrospective study included all 122 consecutive women undergoing a TVT or SPARC midurethral sling procedure for objective stress urinary incontinence between January 2000 and March 2003 at the Evanston Continence Center. Primary outcomes were subjective and objective stress incontinence cure rates. Subjects underwent multichannel urodynamics preoperatively and 14 weeks postoperatively, and stress testing at last follow-up. The two groups were compared using univariate and multivariate analyses. Seventy-three subjects underwent a TVT and 49 subjects had a SPARC procedure. There were no statistical differences in demographic factors between the two groups. Subjects undergoing SPARC were more likely to void by Valsalva effort. One hundred and seven women returned for objective postoperative evaluation after surgery. The TVT procedure was associated with higher subjective (86 vs. 60%, P = 0.001) and objective (95 vs. 70%, P < 0.001) stress incontinence cure rates. There was no difference between the TVT and SPARC groups in the resolution of subjective and objective urge urinary incontinence. TVT was associated with a higher stress urinary incontinence cure rate than SPARC in this retrospective study. As new midurethral sling products are introduced, prospective randomized controlled trials should be conducted to evaluate their relative efficacy and safety.
比较接受SPARC或经阴道无张力尿道中段吊带术（TVT）治疗压力性尿失禁的女性的主观和客观治愈率。这项回顾性研究纳入了2000年1月至2003年3月在埃文斯顿尿失禁中心连续接受TVT或SPARC尿道中段吊带术治疗真性压力性尿失禁的所有122名女性。主要结局指标为主观和客观压力性尿失禁治愈率。受试者在术前和术后14周接受多通道尿动力学检查，并在最后一次随访时进行压力测试。使用单因素和多因素分析对两组进行比较。73名受试者接受了TVT，49名受试者接受了SPARC手术。两组间人口统计学因素无统计学差异。接受SPARC手术的受试者更有可能通过瓦尔萨尔瓦手法排尿。107名女性在术后返回进行客观的术后评估。TVT手术的主观压力性尿失禁治愈率（86%对60%，P = 0.001）和客观治愈率（95%对70%，P < 0.001）更高。TVT组和SPARC组在主观和客观急迫性尿失禁的缓解方面没有差异。在这项回顾性研究中，TVT的压力性尿失禁治愈率高于SPARC。随着新的尿道中段吊带产品的推出，应进行前瞻性随机对照试验以评估它们的相对疗效和安全性。
