Silva-Filho Agnaldo L, Cândido Eduardo B, Noronha Alessandra, Triginelli Sérgio A
Department of Gynecology and Obstetrics, School of Medicine, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190. Santa Efigênia. Belo Horizonte, 30130100 , Minas Gerais, Brazil.
Arch Gynecol Obstet. 2006 Feb;273(5):288-92. doi: 10.1007/s00404-005-0083-1. Epub 2005 Sep 28.
To compare short-term results of autologous pubovaginal sling and synthetic transobturator (TOT) SAFYRE sling in the treatment of female stress urinary incontinence (SUI).
Twenty women referred for surgical treatment of SUI were assigned randomly to autologous pubovaginal sling or synthetic TOT sling. Inclusion criteria were primary treatment of SUI and urodynamic study showing SUI without detrusor overactivity. Pre- and postoperative quantification of the severity of incontinence was done by pad test and a validated questionnaire (King's Health Questionnaire).
There were no differences in patients' mean age, parity, body mass index, rate of postmenopausal state, pelvic floor defects and mean Valsalva leak point pressure in the preoperative urodynamic study. Mean operating time (21.1 +/- 3.8 vs. 69.5 +/- 23.7 min; P < 0.001) and hospital stay (28.8 +/- 8.4 vs. 44.4 +/- 5.8 h; P < 0.001) was shorter in the TOT than the autologous group. The postoperative pad test (39.4 +/- 12.5 vs. 8.4 +/- 5.2 g; P = 0.01) and the absent in the improvement in the quality of life were significantly higher in the TOT group.
Our initial results suggest that the synthetic TOT technique had worse effectiveness for treating female SUI compared to autologous pubovaginal sling.
比较自体耻骨后阴道吊带术与合成材料经闭孔(TOT)SAFYRE吊带术治疗女性压力性尿失禁(SUI)的短期疗效。
20例因SUI需手术治疗的女性被随机分为自体耻骨后阴道吊带术组或合成材料TOT吊带术组。纳入标准为SUI的初次治疗且尿动力学研究显示为无逼尿肌过度活动的SUI。通过卫生巾试验和一份经过验证的问卷(国王健康问卷)对术前和术后失禁严重程度进行量化。
术前尿动力学研究中,两组患者的平均年龄、产次、体重指数、绝经后状态发生率、盆底缺陷及平均Valsalva漏尿点压力均无差异。TOT组的平均手术时间(21.1±3.8 vs. 69.5±23.7分钟;P<0.001)和住院时间(28.8±8.4 vs. 44.4±5.8小时;P<0.001)均短于自体耻骨后阴道吊带术组。TOT组术后卫生巾试验结果(39.4±12.5 vs. 8.4±5.2克;P=0.01)及生活质量改善情况均显著更优。
我们的初步结果表明,与自体耻骨后阴道吊带术相比,合成材料TOT技术治疗女性SUI的效果更差。