Porena Massimo, Lazzeri Massimo, Bini Vittorio, Zucchi Alessandro, del Zingaro Michele, Costantini Elisabetta
Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, Ospedale S Maria della Misericordia Loc S Andrea delle Fratte, Perugia 06100, Italy.
Int Urogynecol J. 2010 Jun;21(6):693-8. doi: 10.1007/s00192-009-1086-4. Epub 2010 Jan 27.
To investigate the outcome of the surgical educational course setting in patients undergoing urinary incontinence (UI)/pelvic organ prolapse (POP) repair.
A case-control study of patients who underwent surgery for UI and/or POP during educational post-graduate courses (group A) or during routine hospital work (control--group B). The primary outcome measures were changes in the incontinence rate, presence/absence of POP, and complications. For 2 x 2 tables, chi (2) test was used. Multivariate logistic regression models were developed.
One hundred eighty-six patients belonged to group A and 158 to group B; median follow-up was 46.7 months. Failure, complication, and re-operation rates for UI repair were not significantly different in the two groups: p = 0.162, p = 0.110, p = 0.188, respectively. The logistic regression analysis for POP repair showed that group A has higher risk for failure (OR = 2.71; 95% CI: 1.31-5.61) and higher complication rate (OR = 2.38; 95% CI: 1.31-4.32).
Patients who underwent surgery during educational course developed a poorer outcome after POP repair and higher complication rate.
探讨在接受尿失禁（UI）/盆腔器官脱垂（POP）修复手术的患者中，外科教育课程设置的效果。
对在研究生教育课程期间（A组）或常规医院工作期间（对照组——B组）接受UI和/或POP手术的患者进行病例对照研究。主要结局指标为失禁率的变化、POP的存在与否以及并发症。对于2×2列联表，使用卡方检验。建立多变量逻辑回归模型。
A组有186例患者，B组有158例患者；中位随访时间为46.7个月。两组UI修复的失败率、并发症率和再次手术率无显著差异：分别为p = 0.162、p = 0.110、p = 0.188。POP修复的逻辑回归分析显示，A组失败风险更高（OR = 2.71；95%置信区间：1.31 - 5.61）且并发症发生率更高（OR = 2.38；95%置信区间：1.31 - 4.32）。
在教育课程期间接受手术的患者，POP修复后结局较差且并发症发生率更高。
