Paick Jae-Seung, Oh Jin Gyu, Shin Jae Wook, Kim Soo Woong, Ku Ja Hyeon
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Int Urol Nephrol. 2007;39(4):1079-84. doi: 10.1007/s11255-006-9156-8. Epub 2007 Mar 2.
The object was to evaluate whether the degree of experience for the tension-free vaginal tape (TVT) procedures influenced the early results of the suprapubic arc (SPARC) sling procedure.
We performed the TVT from March 1999 to May 2003 and SPARC from June to April 2004 by experienced surgeon (A) and inexperienced surgeon (B), respectively. Patients were divided as four subgroups: first 50 patients who underwent the TVT by surgeon A (TVT A); first 15 patients who underwent the TVT by surgeon B (TVT B); first 50 patients who underwent the SPARC by surgeon A (SPARC A); first 15 patients who underwent the SPARC by surgeon B (SPARC B).
Bladder perforations were noted in 4 (8.5%) in the TVT A group and 2 (13.3%) in the TVT B group, respectively (P = 0.626). There was no bladder perforation occurred in the SPARC A and B groups. The rates of transient postoperative urinary retention were 6.4% in the TVT A group and 0.0% in the TVT B group, respectively (P = 1.000). No retention occurred in the SPARC A and B groups. Stress urinary incontinence was cured by 89.4% in the TVT A group and 80.0% in the TVT B group, respectively (P = 0.388). Similar success rates were found in the SPARC A (85.4%) and SPARC B (92.3%) group (P = 1.000).
Our findings suggest that the degree of experience for the TVT procedure does not influence the results of the SPARC procedure during the learning phase.
本研究旨在评估无张力阴道吊带术(TVT)的经验程度是否会影响耻骨上弧形吊带术(SPARC)的早期手术效果。
我们分别于1999年3月至2003年5月及2004年6月至4月,由经验丰富的外科医生(A)和经验不足的外科医生(B)进行TVT和SPARC手术。患者被分为四个亚组:由外科医生A进行TVT手术的前50例患者(TVT A组);由外科医生B进行TVT手术的前15例患者(TVT B组);由外科医生A进行SPARC手术的前50例患者(SPARC A组);由外科医生B进行SPARC手术的前15例患者(SPARC B组)。
TVT A组有4例(8.5%)出现膀胱穿孔,TVT B组有2例(13.3%)出现膀胱穿孔(P = 0.626)。SPARC A组和B组均未发生膀胱穿孔。TVT A组术后短暂性尿潴留发生率为6.4%,TVT B组为0.0%(P = 1.000)。SPARC A组和B组均未发生尿潴留。TVT A组压力性尿失禁治愈率为89.4%,TVT B组为80.0%(P = 0.388)。SPARC A组(85.4%)和SPARC B组(92.3%)的成功率相似(P = 1.000)。
我们的研究结果表明,在学习阶段,TVT手术的经验程度不会影响SPARC手术的效果。