Waltregny David, Gaspar Yves, Reul Olivier, Hamida Wissem, Bonnet Pierre, de Leval Jean
Department of Urology, University Hospital of Liège, Liège, Belgium.
Eur Urol. 2008 Feb;53(2):401-8. doi: 10.1016/j.eururo.2007.08.021. Epub 2007 Aug 21.
Medium-term results of transobturator tapes for the treatment of female stress urinary incontinence (SUI) are largely unknown. We analyzed the 3-yr results of a prospective, observational study designed to evaluate the safety and efficacy of the TVT-O procedure.
Preoperative and postoperative evaluations included physical examination, uroflowmetry and postvoid residual (PVR) measurement, and urinary symptoms and quality of life (QoL) questionnaires. Data were compared by means of the Wilcoxon matched pairs test.
Between March 2003 and December 2003, 102 consecutive patients with clinical and urodynamic diagnoses of SUI who fulfilled inclusion and exclusion criteria underwent the TVT-O procedure; the latter was associated with pelvic organ prolapse treatment in 16 patients (15.7%). Three-year minimum follow-up (median, 40 mo) was available for 91 patients (89.2%). No erosion or persistent pain was noted. Four patients required tape release or section. Disappearance and improvement of SUI were observed in 88.4% and 9.3% of the patients, respectively. These cure rates were similar to those obtained 1 yr after the operation (p=0.55). Frequency and urge symptoms were improved at 3 yr (p<0.005). Whereas maximum flow rates were somewhat decreased (p=0.01), the severity of obstructive symptoms and PVR volumes were not statistically different (p=0.11 and p=0.32, respectively). Incontinence severity and QoL scale scores were largely better than preoperative ones (p<0.001) and did not differ from those reported at 1 yr (p=0.15 and p=0.08, respectively).
The TVT-O procedure is a safe and efficient treatment of female SUI, with maintenance of high cure rates after a 3-yr minimum follow-up.
经闭孔尿道中段悬吊带术治疗女性压力性尿失禁（SUI）的中期结果尚不清楚。我们分析了一项前瞻性观察性研究的3年结果，该研究旨在评估经闭孔尿道中段悬吊带术（TVT-O）的安全性和有效性。
术前和术后评估包括体格检查、尿流率测定和排尿后残余尿量（PVR）测量，以及泌尿系统症状和生活质量（QoL）问卷调查。采用Wilcoxon配对检验对数据进行比较。
2003年3月至2003年12月，102例连续的临床和尿动力学诊断为SUI且符合纳入和排除标准的患者接受了TVT-O手术；其中16例患者（15.7%）同时接受了盆腔器官脱垂治疗。91例患者（89.2%）获得了至少3年的随访（中位随访时间为40个月）。未发现侵蚀或持续性疼痛。4例患者需要松解或切断吊带。分别有88.4%和9.3%的患者尿失禁消失和改善。这些治愈率与术后1年时相似（p = 0.55）。3年时尿频及尿急症状得到改善（p < 0.005）。虽然最大尿流率有所下降（p = 0.01），但梗阻性症状的严重程度和PVR量无统计学差异（分别为p = 0.11和p = 0.32）。尿失禁严重程度和QoL量表评分在很大程度上优于术前（p < 0.001），且与术后1年时报告的结果无差异（分别为p = 0.15和p = 0.08）。
TVT-O手术是治疗女性SUI的一种安全有效的方法，在至少3年的随访后仍保持高治愈率。
