Silva William Andre
Department of Obstetrics and Gynecology, St Francis Hospital, Federal Way, Washington, USA.
Clin Obstet Gynecol. 2007 Jun;50(2):362-75. doi: 10.1097/GRF.0b013e31804a840c.
Two randomized trials have reported no differences in efficacy between suprapubic arc and tension-free vaginal tape at 2 years. There are no long-term studies comparing the inside-out and outside-in transobturator (TOT) approach, although short-term data show no difference in cure rates or complications. The short-term efficacy of TOT midurethral slings is comparable with the retropubic slings; however, preliminary evidence suggests that TOT slings may have a lower success rate compared with retropubic slings for the treatment of intrinsic sphincter deficiency. The risk of bladder injury may be the least with the "inside-out" approach, whereas retropubic techniques have a higher risk of cystotomy as compared with the TOT approach. Four randomized controlled trials comparing the retropubic and TOT approaches show no differences in rate of de novo urgency, retention, frequency, nocturia, or incomplete voiding.
两项随机试验报告称，耻骨上弧形吊带术与无张力阴道吊带术在2年时的疗效无差异。目前尚无比较经闭孔内入路和经闭孔外入路（TOT）的长期研究，不过短期数据显示治愈率或并发症方面并无差异。TOT 中尿道吊带的短期疗效与耻骨后吊带相当；然而，初步证据表明，在治疗内在括约肌缺陷方面，TOT吊带的成功率可能低于耻骨后吊带。“由内向外”入路导致膀胱损伤的风险可能最低，而与TOT入路相比，耻骨后技术导致膀胱切开术的风险更高。四项比较耻骨后入路和TOT入路的随机对照试验表明，新发尿急、尿潴留、尿频、夜尿或排尿不完全的发生率并无差异。
