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经闭孔聚丙烯带由外向内置入术治疗女性压力性尿失禁:1年最小随访期的前瞻性研究及经闭孔吊带术综述

Transobturator tape sling for female stress incontinence with polypropylene tape and outside-in procedure: prospective study with 1 year of minimal follow-up and review of transobturator tape sling.

作者信息

Grise Philippe, Droupy Stephane, Saussine Christian, Ballanger Philippe, Monneins Francois, Hermieu Jean Francois, Serment Gerard, Costa Pierre

机构信息

Department of Urology, Rouen University Hospital, Rouen, France.

出版信息

Urology. 2006 Oct;68(4):759-63. doi: 10.1016/j.urology.2006.04.020.

Abstract

OBJECTIVES

To assess the efficacy and safety of a minimally invasive surgical procedure using a polypropylene transobturator tape to treat female stress urinary incontinence during a minimal follow-up of 1 year and to present a review of this technique.

METHODS

A total of 206 women with stress urinary incontinence who underwent the transobturator tape procedure in a French multicenter prospective open tracker study, with a minimal follow-up of 1 year (range 12 to 33 months), were assessed. A nonelastic, polypropylene tape was placed under the mid-urethra. The surgical placement technique used a vaginal and transobturator percutaneous approach. Postoperative assessments included clinical examination, cough-stress test (full bladder), uroflowmetry, and postvoid residual urine volume performed after 1, 6, 12, 18, and 24 months.

RESULTS

The mean follow-up was 16 months (range 12 to 33). Of the 206 patients, 79.1% were completely cured, 13% improved, and 7% failed. No vascular, nervous system, or digestive perioperative complications were observed; however, 2.4% of the patients had postoperative urinary retention.

CONCLUSIONS

The results of the present study have confirmed the optimal results in stress incontinence previously reported in short-term studies. These results suggest that the transobturator tape procedure is a valuable alternative to the transvaginal tape procedure, with a low rate of complications.

摘要

目的

评估采用聚丙烯经闭孔带的微创手术治疗女性压力性尿失禁在至少1年随访期内的疗效和安全性,并对该技术进行综述。

方法

在一项法国多中心前瞻性开放追踪研究中,对206例接受经闭孔带手术的压力性尿失禁女性进行了评估,随访期至少1年(范围为12至33个月)。将一条无弹性的聚丙烯带置于尿道中段下方。手术放置技术采用阴道和经闭孔经皮入路。术后评估包括临床检查、咳嗽压力试验(膀胱充盈)、尿流率测定以及在1、6、12、18和24个月后进行的排尿后残余尿量测定。

结果

平均随访时间为16个月(范围为12至33个月)。206例患者中,79.1%完全治愈,13%有所改善,7%治疗失败。未观察到血管、神经系统或消化系统围手术期并发症;然而,2.4%的患者出现术后尿潴留。

结论

本研究结果证实了先前短期研究中报道的压力性尿失禁的最佳治疗效果。这些结果表明,经闭孔带手术是经阴道带手术的一种有价值的替代方法,并发症发生率低。

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