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[不同尿道下吊带治疗压力性尿失禁的比较]

[Comparison of diferents suburethral slings for the treatment of stress urinary incontinence].

作者信息

Borrell Palanca A, Chicote Pérez F, Beltrán Meseguer J F, Queipo Zaragozá J A, Esteve Claramunt J, Pastor Sempere F

机构信息

Servicio de Urología, Hospital de Sagunt, Port de Sagunt, Valencia.

出版信息

Actas Urol Esp. 2005 Sep;29(8):757-63. doi: 10.1016/s0210-4806(05)73337-4.

DOI:10.1016/s0210-4806(05)73337-4
PMID:16304907
Abstract

OBJECTIVES

To compare the results of the different procedures of sling suburetral used in our service (TVT, Sparc, IVS, Obtape and Monarc) for the treatment of the female urinary incontinence.

MATERIAL AND METHODS

96 patients retrospective analysis affects of female urinary incontinence and subjected to different procedures of sling suburethral without tension. The half age: 56.1 +/- 10.7 years. 75 patients were intervened by means of procedures retropubics (48 TVT, 17 Sparc, 10 IVS) and 21 with obturators (10 Obtape, 11 Monarc). The half time of pursuit: 26.3 +/- 12.7 months (29.4 months for the methods retropubics and 11.7 for the obturators). The analyzed variables were: age, obesity, grade of previous incontinence, type of used procedure, time of pursuit, and previous surgical procedures. We compare the complications and the results obtained with the different ones technical.

RESULTS

the cure percentage was of 95.7%. 7 patients presented complications: one intestinal perforation, two bladders perforations, one erosion of vaginal wall, three incontinences of novo urgency. In 6 cases the stress incontinence persists. When analyzing the association between the diverse variables and the success, we appreciate that the variables with value presage were the age and the obesity (P < 0.05) not observing relationship with the technique employeed.

CONCLUSIONS

The existence of multiple surgical approachs and a varied auxiliary materials allow each surgeon to choose that with the one that is more familiarized and comfortable without, seemingly, influence it in the results.

摘要

目的

比较我院用于治疗女性尿失禁的不同耻骨后尿道下吊带手术(经阴道无张力尿道中段吊带术[TVT]、 Sparc手术、IVS手术、Obtape手术和Monarc手术)的效果。

材料与方法

对96例接受不同无张力耻骨后尿道下吊带手术的女性尿失禁患者进行回顾性分析。平均年龄:56.1±10.7岁。75例患者采用耻骨后途径手术(48例TVT手术、17例Sparc手术、10例IVS手术),21例采用闭孔途径手术(10例Obtape手术、11例Monarc手术)。平均随访时间:26.3±12.7个月(耻骨后途径手术为29.4个月,闭孔途径手术为11.7个月)。分析的变量包括:年龄、肥胖程度、既往尿失禁分级、所用手术类型、随访时间和既往手术史。我们比较了不同技术的并发症和结果。

结果

治愈率为95.7%。7例出现并发症:1例肠穿孔、2例膀胱穿孔、1例阴道壁糜烂、3例新发急迫性尿失禁。6例压力性尿失禁持续存在。在分析不同变量与手术成功之间的关联时,我们发现有预示价值的变量是年龄和肥胖程度(P<0.05),未观察到与所采用技术的相关性。

结论

多种手术方法和多样的辅助材料的存在使每位外科医生能够选择自己更熟悉和操作更顺手的方法,而这似乎并未影响手术结果。

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引用本文的文献

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Randomized trial of graft materials in transobturator tape operation: biological versus synthetic.经闭孔尿道中段无张力吊带手术中移植物材料的随机试验:生物材料与合成材料对比
Int Urogynecol J. 2013 Aug;24(8):1315-23. doi: 10.1007/s00192-012-2008-4. Epub 2012 Nov 27.
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Retropubic and transobturator midurethral slings: a decision analysis to compare outcomes including efficacy and complications.
耻骨后和经闭孔尿道中段吊带术:一项比较包括疗效和并发症在内的结果的决策分析
Int Urogynecol J. 2010 Jul;21(7):787-93. doi: 10.1007/s00192-010-1121-5. Epub 2010 Feb 26.
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Comparison of retropubic vs transobturator approach to midurethral slings: a systematic review and meta-analysis.耻骨后与经闭孔途径治疗中段尿道吊带术的比较:一项系统评价和荟萃分析。
Am J Obstet Gynecol. 2007 Jul;197(1):3-11. doi: 10.1016/j.ajog.2006.09.025.