Wilson Christopher M, Williams B Jill, Bilello Seth, Gomelsky Alex
Department of Urology, Louisiana State University Health Sciences Center, Shreveport 1501 Kings Highway, Shreveport, LA, 71130, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Dec;19(12):1671-6. doi: 10.1007/s00192-008-0703-y. Epub 2008 Aug 9.
Women at high risk for sling failure (advanced age, previous surgical failure, and intrinsic sphincter deficiency) underwent either bovine dermis (BOV) or autologous rectus fascia (ARF) pubovaginal sling at two hospitals. "Global cure" encompassed stress, emptying, anatomic, protection, and instability (SEAPI) composite = 0 and subjective satisfaction. Cure of stress urinary incontinence (SUI cure) equaled SEAPI (S) = 0 and negative cough-stress test. Eighty-five women (48 ARF, 37 BOV) completed a 12-month evaluation. Preoperative SEAPI and quality of life indices (QOL) were not statistically different (NS). "Global cure" for ARF and BOV was 60.4% and 54.1%, respectively (NS). "SUI cure" for ARF and BOV was 81.3% and 83.8%, respectively (NS). Postoperative SEAPI and QOL indices were significantly improved for each material; improvement was similar between ARF and BOV groups (NS). BOV is a promising substitute for ARF in women at high risk for surgical failure. Longer follow-up is needed before indications for this material are expanded.
在两家医院，对吊带手术失败风险较高（高龄、既往手术失败以及固有括约肌缺陷）的女性进行了牛真皮（BOV）或自体腹直肌筋膜（ARF）耻骨阴道吊带手术。“整体治愈”包括压力性、排空性、解剖学、保护性和不稳定性（SEAPI）综合评分 = 0 以及主观满意度。压力性尿失禁的治愈（SUI 治愈）等于 SEAPI（S）= 0 且咳嗽压力试验为阴性。85 名女性（48 名 ARF，37 名 BOV）完成了为期 12 个月的评估。术前 SEAPI 和生活质量指数（QOL）无统计学差异（NS）。ARF 和 BOV 的“整体治愈”率分别为 60.4%和 54.1%（NS）。ARF 和 BOV 的“SUI 治愈”率分别为 81.3%和 83.8%（NS）。每种材料术后的 SEAPI 和 QOL 指数均显著改善；ARF 组和 BOV 组之间的改善情况相似（NS）。对于手术失败风险较高的女性，BOV 是 ARF 的一种有前景的替代材料。在扩大该材料的适应证之前，需要更长时间的随访。
