Kociszewski Jacek, Rautenberg Oliver, Kolben Sebastian, Eberhard Jakob, Hilgers Reinhard, Viereck Volker
Department of Gynecology and Obstetrics, Evangelisches Krankenhaus, Hagen-Haspe, Hagen, Germany.
Int Urogynecol J. 2010 Jul;21(7):795-800. doi: 10.1007/s00192-010-1119-z. Epub 2010 Mar 4.
This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome.
Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence.
At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence.
Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.
本研究评估了体内条件下胶带位置及形状变化（胶带功能）对中期结果的相关性。
对41例压力性尿失禁女性患者，在6个月和48个月后，测定超声下无张力阴道吊带（TVT）位置相对于尿道长度百分比及吊带 - 尿道距离的变化。
48个月时，76%（31/41）的女性治愈，17%（7/41）改善，7%（3/41）治疗失败。12%（5/41）存在膀胱排尿障碍，7%（3/41）出现新发急迫性尿失禁。TVT位置中位数为尿道长度的63%。吊带 - 尿道距离中位数为2.7 mm，无并发症的控尿患者为2.9 mm，有梗阻性并发症的患者为1.1 mm。术后有尿失禁的患者该距离中位数为3.9 mm。48个月时，41例女性中有15例（37%）在静息时吊带伸展，用力时呈C形（均为控尿状态）。6个月时具有这种吊带功能的患者，48个月时86%（19/22）治愈，仅14%（3/22）出现复发性尿失禁。
中期数据表明，如果吊带在尿道中、远三分之一交界处距尿道至少2 mm处定位，则可能获得最佳结果。6个月时具有最佳吊带功能的患者可能取得中期治疗成功。
