Sharp Victoria J, Bradley Catherine S, Kreder Karl J
Department of Urology, University of Iowa, Iowa City, Iowa 52242-1089, USA.
Curr Opin Urol. 2006 Jul;16(4):224-8. doi: 10.1097/01.mou.0000232040.49686.e1.
To review recently published studies on stress urinary incontinence surgery outcomes in older women.
Five prospective and two retrospective studies were identified that reported tension-free vaginal tape (n = 6), colposuspension (n = 1) and cadaveric fascia transvaginal sling (n = 1) procedure results. In each study, 21-175 older women were included, with mean ages ranging from 71 to 83 years; most studies included younger comparison groups. Mean follow-ups ranged from 3 to 30 months. Subjective stress urinary incontinence 'cure/improvement' rates after surgery were significantly lower in older women when compared with younger women in only one study, although similar trends were seen in two additional studies. Intraoperative complications occurred at similar rates in older and younger women. Postoperative complications (urinary tract infection, urgency, voiding dysfunction, and mesh erosion) were more common in older women in only a few studies.
Recent studies demonstrate that surgery for stress urinary incontinence in older women improves symptoms, although in some reports, not to the extent seen in younger women. It is unclear if some postoperative complications are more common in older women undergoing incontinence surgery. Results from randomized trials focusing on stress urinary incontinence surgery in older women are needed.
综述近期发表的关于老年女性压力性尿失禁手术结局的研究。
共纳入五项前瞻性研究和两项回顾性研究，这些研究报告了无张力阴道吊带术（n = 6）、阴道前壁修补术（n = 1）和尸体筋膜经阴道吊带术（n = 1）的手术结果。每项研究纳入21至175名老年女性，平均年龄在71至83岁之间；大多数研究纳入了较年轻的对照组。平均随访时间为3至30个月。在仅一项研究中，老年女性术后主观压力性尿失禁“治愈/改善”率显著低于年轻女性，另外两项研究也观察到了类似趋势。老年女性和年轻女性术中并发症发生率相似。仅在少数研究中，老年女性术后并发症（尿路感染、尿急、排尿功能障碍和网片侵蚀）更为常见。
近期研究表明，老年女性压力性尿失禁手术可改善症状，尽管在一些报告中，改善程度不及年轻女性。尚不清楚失禁手术老年女性的某些术后并发症是否更常见。需要开展针对老年女性压力性尿失禁手术的随机试验。
