术前最大尿道闭合压（MUCP）和腹压漏尿点压（VLPP）不能预测经闭孔尿道中段吊带术后的长期（4年）结局。

Preoperative MUCP and VLPP did not predict long-term (4-year) outcome after transobturator mid-urethral sling.

作者信息

Costantini Elisabetta, Lazzeri Massimo, Giannantoni Antonella, Bini Vittorio, del Zingaro Michele, Porena Massimo

机构信息

Section of Urology and Andrology, Department of Medical-Surgical Specialties and Public Health, University of Perugia, Perugia, Italy.

出版信息

Urol Int. 2009;83(4):392-8. doi: 10.1159/000251177. Epub 2009 Dec 8.

DOI:10.1159/000251177

PMID:19996644

Abstract

OBJECTIVE

Maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (VLPP) have been considered objective parameters for studying the urethral integrity and predicting outcome after surgery for stress urinary incontinence (SUI). We test the hypothesis that preoperative MUCP and/or VLPP may predict long-term outcome after out-in transobturator tape (TOT) surgery for female SUI.

METHODS

65 patients affected by stress or mixed urinary incontinence were enrolled in a prospective observational descriptive study conducted from May 2002 to November 2005 at a single tertiary urban teaching university urogynecological department. Preoperative MUCP and VLPP, stratified as < or = or >40 cm H(2)O and < or = or >60 cm H(2)O, respectively, were separately or in combination correlated with primary (continence status: dry or wet) and secondary outcome variables (quality of life questionnaires) after surgery.

RESULTS

Out of 65 patients, 6 (9.2%) did not attend the follow-up. The median follow-up was 46 months (mean 52 +/- 18; range 36-82). The overall objective cure rates (dry) were 74.4% for patients with VLPP >60 cm H(2)O and 65% for VLPP < or =60 cm H(2)O (p < 0.654). The overall objective cure rates (dry) were 75% for patients with MUCP >40 cm H(2)O and 68.6% for MUCP < or =40 cm H(2)O (p < 0.808). The overall objective cure rates (dry) were 82.4% for patients with MUCP >40 cm H(2)O and VLPP >60 cm H(2)O and 69.2% for MUCP < or =40 cm H(2)O and VLPP < or =60 cm H(2)O (p < 0.956).

CONCLUSIONS

These data seem to cast doubts on the predictive value of MUCP and VLPP in patients who underwent TOT.

摘要

目的

最大尿道闭合压（MUCP）和瓦尔萨尔瓦漏尿点压（VLPP）被视为研究尿道完整性以及预测压力性尿失禁（SUI）手术后疗效的客观参数。我们检验这样一个假设，即术前MUCP和/或VLPP可能预测女性SUI经闭孔尿道中段吊带术（TOT）后的长期疗效。

方法

2002年5月至2005年11月，在一所城市三级教学大学的单一泌尿妇科科室，对65例患有压力性或混合性尿失禁的患者进行了一项前瞻性观察描述性研究。术前MUCP和VLPP分别分层为≤或＞40 cm H₂O以及≤或＞60 cm H₂O，分别单独或联合与手术后的主要结局变量（控尿状态：干爽或潮湿）和次要结局变量（生活质量问卷）进行相关性分析。

结果

65例患者中，6例（9.2%）未参加随访。中位随访时间为46个月（平均52±18；范围36 - 82个月）。VLPP＞60 cm H₂O的患者总体客观治愈率（干爽）为74.4%，VLPP≤60 cm H₂O的患者为65%（p＜0.654）。MUCP＞40 cm H₂O的患者总体客观治愈率（干爽）为75%，MUCP≤40 cm H₂O的患者为68.6%（p＜0.808）。MUCP＞40 cm H₂O且VLPP＞60 cm H₂O的患者总体客观治愈率（干爽）为82.4%，MUCP≤40 cm H₂O且VLPP≤60 cm H₂O的患者为69.2%（p＜0.956）。