Rechberger Tomasz, Adamiak Aneta, Jankiewicz Katarzyna, Skorupski Paweł, Wróbel Andrzej, Tomaszewski Jacek, Futyma Konrad
II Katedra i Klinika Ginekologii, Akademii Medycznej w Lublinie.
Ginekol Pol. 2007 Apr;78(4):299-302.
The prospective comparison of the clinical effectiveness and the complication rate of retropubic (IVS-02) and transobturator (IVS-04) midurethral slings in the treatment of female stress urinary incontinence.
The purpose of this study was the prospective comparison of clinical efficacy and safety of retropubic (IVS-02) and transobturator suburethral tape techniques (IVS-04) in the treatment of female stress urinary incontinence.
From January 2003 to June 2004, 145 patients with uro-dynamically proven stress urinary incontinence underwent surgical treatment (IVS-02 or IVS-04). During pretreatment work-up, all patients had under-gone full clinical and urodynamic evaluation. Patients with mixed, urge incontinence and the advanced urogenital prolapse (POPQ scale > 2) were excluded from the study.
Patients clinical characteristics and urodynamic parameters were comparable between the analyzed groups. At one year follow-up, 122 patients (61 in each group) were evaluated in terms of clinical efficacy of the procedure. The total cure (78.7% in IVS-02 vs 70.5% in IVS-04), the improvement (14.7% vs 21.3%) and the failure rates (6.6% vs 8.2%) were similar in both analyzed groups, chi2 = 0.58; (p = 0.75).
The transobturator route for the treatment of stress urinary incontinence appears to be as effective as the retropubic one at one year follow-up. Moreover, the shorter operation time and no need to perform cystoscopy during the surgery make the transoburator route a very attractive alternative to retropubic approach.
耻骨后(IVS - 02)和经闭孔(IVS - 04)两种尿道中段吊带术治疗女性压力性尿失禁的临床疗效及并发症发生率的前瞻性比较。
本研究旨在对耻骨后(IVS - 02)和经闭孔尿道下吊带术(IVS - 04)治疗女性压力性尿失禁的临床疗效及安全性进行前瞻性比较。
2003年1月至2004年6月,145例经尿动力学证实为压力性尿失禁的患者接受了手术治疗(IVS - 02或IVS - 04)。在术前检查期间,所有患者均接受了全面的临床和尿动力学评估。混合性、急迫性尿失禁以及重度泌尿生殖器官脱垂(POPQ量表评分>2)的患者被排除在研究之外。
各分析组患者的临床特征和尿动力学参数具有可比性。在一年随访时,对122例患者(每组61例)进行了手术临床疗效评估。两组的总治愈率(IVS - 02组为78.7%,IVS - 04组为70.5%)、改善率(14.7%对21.3%)和失败率(6.6%对8.2%)相似,卡方检验=0.58;(p = 0.75)。
在一年随访时,经闭孔途径治疗压力性尿失禁似乎与耻骨后途径同样有效。此外,手术时间较短且术中无需进行膀胱镜检查,使得经闭孔途径成为耻骨后途径极具吸引力的替代方法。