Joo Young Min, Choe Jin Ho, Seo Ju Tae
Department of Urology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea.
Korean J Urol. 2010 May;51(5):337-43. doi: 10.4111/kju.2010.51.5.337. Epub 2010 May 19.
We compared the efficacy and safety of two minimally invasive sling procedures used to treat female stress urinary incontinence (SUI), tension-free vaginal tape (TVT) SECUR(R) and CureMesh(R), and assessed the 1-year surgical outcomes.
Sixty women with SUI were assigned to undergo either the TVT SECUR (n=38) or CureMesh (n=22) procedures between April 2007 and June 2008. Patients were monitored via outpatient visits at 1 month, 3 months, and 1 year after surgery. The efficacy of these procedures was evaluated by the cough test or by a urodynamic study. At these postoperative visits, the patients also completed several questionnaires, including incontinence quality of life, patient's perception of urgency severity, the scored form of the Bristol Female Lower Urinary Tract Symptoms, visual analog scale, and questions about perceived benefit, satisfaction, and willingness to undergo the same operation again. The objective cure rate was defined as no leakage during the cough test with a full bladder. The subjective cure rate was evaluated by self-assessment of goal achievement performed 1 year postoperatively.
The two groups were similar in preoperative characteristics and urodynamic parameters. The objective cure rates were similar between TVT SECUR and CureMesh (68.4% vs. 77.3%). All respondents reported improvement after surgery. There were no intra-operative complications.
Our results showed that the TVT SECUR and CureMesh procedures are both safe and simple to perform and have no significant differences in efficacy. Comparative studies with long-term follow-up are warranted to determine the true efficacy of these procedures.
我们比较了两种用于治疗女性压力性尿失禁(SUI)的微创吊带手术——无张力阴道吊带(TVT)SECUR和CureMesh的疗效和安全性,并评估了1年的手术效果。
2007年4月至2008年6月期间,60例SUI女性被分配接受TVT SECUR手术(n = 38)或CureMesh手术(n = 22)。术后1个月、3个月和1年通过门诊随访对患者进行监测。通过咳嗽试验或尿动力学研究评估这些手术的疗效。在这些术后随访中,患者还完成了几份问卷,包括尿失禁生活质量、患者对尿急严重程度的感知、布里斯托尔女性下尿路症状评分表、视觉模拟量表,以及关于感知益处、满意度和是否愿意再次接受相同手术的问题。客观治愈率定义为膀胱充盈时咳嗽试验无漏尿。主观治愈率通过术后1年对目标达成情况的自我评估来评价。
两组术前特征和尿动力学参数相似。TVT SECUR和CureMesh的客观治愈率相似(68.4%对77.3%)。所有受访者均报告术后有改善。术中无并发症。
我们的结果表明,TVT SECUR和CureMesh手术操作安全且简单,疗效无显著差异。有必要进行长期随访的比较研究以确定这些手术的真正疗效。