de Leval Jean, Thomas Alexandre, Waltregny David
Department of Urology, University Hospital of Liège, Liège, Belgium.
Int Urogynecol J. 2011 Feb;22(2):145-56. doi: 10.1007/s00192-010-1264-4. Epub 2010 Sep 21.
The aim of this study is to compare a modified inside-out transobturator procedure with its original counterpart [inside-out transobturator (TVT-O)] for the treatment of female stress urinary incontinence (SUI).
A prospective, randomized trial in women suffering from SUI was used. The modified procedure consisted of a shorter tape whilst the scissors or guide no longer perforated the obturator membrane. The primary outcome was the resolution of subjective and objective SUI at 1 year. Secondary outcome measures included adverse events, quality of life measures, and groin pain.
One hundred seventy-five patients were randomized. No intraoperative complications were recorded. The SUI cure rate was 91.7% versus 90.7% (original versus modified, respectively; p = 0.824). Incidence and intensity of groin pain was higher in the original TVT-O group on day 0 and 1 (p < 0.05), requiring more analgesics (p = 0.015) but not thereafter.
At 1 year follow-up, the modified inside-out transobturator tape procedure was as efficient and safe as the original technique but associated with less immediate postoperative groin pain.
本研究旨在比较改良的经闭孔由内向外手术与其原手术方式[经闭孔由内向外（TVT - O）]治疗女性压力性尿失禁（SUI）的效果。
对患有SUI的女性进行一项前瞻性随机试验。改良手术使用的吊带较短，且剪刀或导针不再穿透闭孔膜。主要结局指标是1年时主观和客观SUI的缓解情况。次要结局指标包括不良事件、生活质量指标和腹股沟疼痛。
175例患者被随机分组。未记录到术中并发症。SUI治愈率分别为91.7%和90.7%（原手术与改良手术，p = 0.824）。在第0天和第1天，原TVT - O组腹股沟疼痛的发生率和强度更高（p < 0.05），需要更多的镇痛药（p = 0.015），但之后则不然。
在1年随访时，改良的经闭孔由内向外吊带手术与原技术一样有效且安全，但术后即刻腹股沟疼痛较少。
