逼尿肌过度活动与男性骨锚定会阴吊带术后结果的关系。

Association between detrusor overactivity and postoperative outcomes in patients undergoing male bone anchored perineal sling.

机构信息

University of Kentucky, Lexington, Kentucky 40536-0298, USA.

出版信息

J Urol. 2010 Feb;183(2):641-5. doi: 10.1016/j.juro.2009.10.008. Epub 2009 Dec 16.

DOI:10.1016/j.juro.2009.10.008

PMID:20018325

Abstract

PURPOSE

In this study we determined if there was an association between the presence of preoperative detrusor overactivity and patient outcomes after bone anchored perineal sling.

MATERIALS AND METHODS

A total of 85 men underwent a male perineal sling procedure for urodynamically proven stress urinary incontinence. Preoperative history and physical examination were performed, and patients completed self-assessment questionnaires. Based on urodynamics patients were divided into 2 groups of those with and those without detrusor overactivity. Questionnaires including the Patient Global Impression of Improvement Scale were readministered postoperatively. Success was defined by the Patient Global Impression of Improvement as very much better or much better. Failure was defined by the responses of a little better, no change, a little worse or much worse. Successes and failures were compared to the presence of detrusor overactivity. Preoperative parameters, preoperative and postoperative questionnaire scores, and postoperative pad and anticholinergic use were compared between the 2 groups.

RESULTS

A total of 72 patients were included in the analysis, and of these 22 (30.6%) had detrusor overactivity and 50 (69.4%) did not. All patients completed the Patient Global Impression of Improvement. There was no statistical difference in the number of cases classified as successes or failures in the 2 groups (p = 0.4213). A significantly higher percentage of patients with detrusor overactivity required postoperative anticholinergics. There was no statistical difference in the number of patients using pads postoperatively.

CONCLUSIONS

Preoperative detrusor overactivity was not associated with worse postoperative outcomes. Men with urodynamic stress urinary incontinence and detrusor overactivity may be considered for a male sling procedure. However, they may require postoperative anticholinergics and should be counseled accordingly.

摘要

目的

本研究旨在确定术前逼尿肌过度活动与骨锚定会阴吊带术后患者结局之间是否存在关联。

材料和方法

共有 85 名男性因尿动力学证实的压力性尿失禁接受了男性会阴吊带手术。进行了术前病史和体格检查，患者完成了自我评估问卷。根据尿动力学检查，患者分为逼尿肌过度活动组和无逼尿肌过度活动组。术后重新使用包括患者总体改善印象量表在内的问卷。将非常明显改善或明显改善定义为成功，将略有改善、无变化、略有恶化或明显恶化定义为失败。将成功和失败与逼尿肌过度活动进行比较。比较两组之间术前参数、术前和术后问卷评分以及术后尿垫和抗胆碱能药物的使用情况。

结果

共有 72 例患者纳入分析，其中 22 例（30.6%）存在逼尿肌过度活动，50 例（69.4%）不存在逼尿肌过度活动。所有患者均完成了患者总体改善印象量表。两组中被归类为成功或失败的病例数量没有统计学差异（p=0.4213）。逼尿肌过度活动组需要术后抗胆碱能药物的患者比例明显更高。术后使用尿垫的患者数量无统计学差异。