Taweel Waleed Al, Rabah Danny M
King Faisal Specialist Hospital and Research Centre, Alfaisal University, Riyadh, Saudi Arabia, and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Can Urol Assoc J. 2010 Feb;4(1):33-6. doi: 10.5489/cuaj.08118.
The objective of this paper is to evaluate the effectiveness of transobturator vaginal tape (TOT) in the treatment of female stress urinary incontinence (SUI) and to analyze functional results and quality of life after 24 months follow-up.
The study included all women with SUI who underwent a TOT procedure in which the sling passes from the obturator foramen from the outside to the inside, under general or regional anesthesia from December 2004 to January 2006. All study patients must have had a minimal follow-up of 24 months. The patients were prospectively evaluated, and the following factors were assessed: number of pads used per day, physical examination including pelvic examination, urinalysis, urogenital distress inventory (UDI-6), analog global satisfaction scale (GSS), pad weight test, and urodynamic studies including filling cystometry and Valsalva leak point pressure (VLPP) test.
Fifty-two consecutive patients who fulfilled the inclusion criteria underwent TOT procedure by 1 surgeon. The mean age was 50 +/-9 (range 37-72) and minimal follow-up was 24 months (range 24-30 months). Two patients were lost to follow-up after 12 months and 3 patients did not come for the 24-month evaluation. The mean operative time was 18 minutes +/-4 (range 15-31), with an average amount of bleeding 57 cc +/-22cc. Our results demonstrate a 92% cure or improvement rate after 12 months, and an 85% after 24 months.
The transobturator approach from outside to inside is a very effective treatment of SUI with low morbidity. However, longer follow-up in larger populations should assess the long-term reliability of this procedure.
本文旨在评估经闭孔阴道吊带术（TOT）治疗女性压力性尿失禁（SUI）的有效性，并分析24个月随访后的功能结果和生活质量。
该研究纳入了2004年12月至2006年1月期间在全身或区域麻醉下接受TOT手术（吊带从闭孔从外向内穿过）的所有SUI女性患者。所有研究患者的随访时间均至少为24个月。对患者进行前瞻性评估，并评估以下因素：每日使用的尿垫数量、体格检查（包括盆腔检查）、尿液分析、泌尿生殖系统困扰量表（UDI-6）、整体满意度模拟量表（GSS）、尿垫重量试验以及尿动力学研究（包括膀胱测压和瓦尔萨尔瓦漏尿点压力（VLPP）试验）。
1名外科医生为52例符合纳入标准的连续患者实施了TOT手术。平均年龄为50±9岁（范围37 - 72岁），最短随访时间为24个月（范围24 - 30个月）。2例患者在12个月后失访，3例患者未前来进行24个月评估。平均手术时间为18分钟±4分钟（范围15 - 31分钟），平均出血量为57毫升±22毫升。我们的结果显示，12个月后治愈率或改善率为92%，24个月后为85%。
从外向内的经闭孔入路是一种治疗SUI的非常有效的方法，发病率低。然而，需要在更大规模人群中进行更长时间的随访，以评估该手术的长期可靠性。
