Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent, UK.
BJOG. 2010 May;117(6):730-5. doi: 10.1111/j.1471-0528.2010.02513.x. Epub 2010 Feb 22.
To compare a mini-sling with a retropubic tension-free vaginal tape (TVT) in the treatment of stress urinary incontinence (SUI) and urodynamic stress incontinence (USI).
Randomised trial.
Urogynaecology unit in large UK district general hospital.
Women with USI resistant to conservative management and requiring a suburethral sling.
A total of 71 women with SUI and confirmed USI were randomised to undergo treatment with either a retropubic TVT or mini-sling. Follow-up was at 6 weeks, with a history, examination and quality of life questionnaire, and at 6 months with further subjective evaluation and twin-channel subtraction cystometry and pressure-flow studies.
The presence of SUI at 6 weeks and 6 months after treatment.
The mini-sling was associated with a significantly higher rate of persistent SUI at 6 weeks (OR 9.49, 95% CI 2.8-32.6) and 6 months (OR 8.14, 95% CI 2.7-24.7), and of USI at 6 months (OR 7.58, 95% CI 2.7-24.7). The rate of complication was similar in the two groups.
The mini-sling is associated with a higher failure rate than a retropubic TVT. Longer term and multicentre outcome data are necessary to explore these findings further. Until this is available, the mini-sling should be used with caution.
比较迷你吊带与经耻骨后无张力阴道吊带（TVT）治疗压力性尿失禁（SUI）和尿动力学压力性尿失禁（USI）的效果。
随机试验。
英国大型地区综合医院泌尿科。
经保守治疗无效且需要尿道下吊带的 USI 女性。
共有 71 名 SUI 合并确诊 USI 的女性患者被随机分为经耻骨后 TVT 或迷你吊带治疗组。在 6 周时进行随访，包括病史、检查和生活质量问卷，在 6 个月时进行进一步的主观评估和双通道减法膀胱测压和压力流研究。
治疗后 6 周和 6 个月时 SUI 的存在情况。
迷你吊带在治疗后 6 周和 6 个月时持续性 SUI 的发生率明显更高（OR 9.49，95%CI 2.8-32.6；OR 8.14，95%CI 2.7-24.7），且 USI 的发生率在 6 个月时也更高（OR 7.58，95%CI 2.7-24.7）。两组的并发症发生率相似。
迷你吊带的失败率高于经耻骨后 TVT。需要进一步探索这些发现的长期和多中心结局数据。在获得这些数据之前，应谨慎使用迷你吊带。
