Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea.
Int Neurourol J. 2010 Apr;14(1):13-9. doi: 10.5213/inj.2010.14.1.13. Epub 2010 Apr 30.
The purpose of our study was to evaluate the influence of obesity on clinical characteristics, quality of life (QoL), and outcomes in patients with stress urinary incontinence (SUI) who underwent the transobturator tape (TOT) surgery.
The medical records of SUI patients who underwent the TOT operation from January 2007 to February 2009 were retrospectively reviewed. Patients with any neurologic diseases that affect the voiding pattern were excluded, and 107 patients were enrolled. The patients were divided into nonobese (BMI<25) and obese (BMI≥25) groups. The preoperative evaluation consisted of history taking, physical examination, cystometrography, 3-day frequency-volume chart, King's Health Questionnaire (KHQ), and symptom perception scale questionnaires.
The nonobese group consisted of 55 (51.4%) patients and the obese group of 52 (48.6%). The median age was 49.0 (range, 30.8-73.5) years in the nonobese group and 52.7 (range, 35.5-73.5) years in the obese group (p>0.05). The obese group showed a higher SUI symptom grade, urethral hypermobility, urgency, and urge incontinence scale than did the nonobese group (each p<0.05). Neither the domains of the KHQ nor the items on the 3-day frequency-volume chart differed between the two groups (each p>0.05). After the operation, the symptom scales and parameters in the 3-day frequency-volume chart of the obese group were similar to those of the nonobese group (each p>0.05). The objective success, recurrence, and complication rates at 1year were similar in the two groups (each p>0.05).
Obese SUI patients had worse SUI symptom grade, urgency, and urge incontinence symptoms than did nonobese patients. However, surgical correction by the TOT operation could restore the symptoms and voiding parameters as effectively in obese patients as in nonobese patients.
本研究旨在评估肥胖对行经闭孔吊带(TOT)手术的压力性尿失禁(SUI)患者的临床特征、生活质量(QoL)和结局的影响。
回顾性分析 2007 年 1 月至 2009 年 2 月接受 TOT 手术的 SUI 患者的病历。排除任何影响排尿模式的神经疾病患者,共纳入 107 例患者。患者分为非肥胖组(BMI<25)和肥胖组(BMI≥25)。术前评估包括病史采集、体格检查、膀胱测压、3 天频率-容积图表、King 健康问卷(KHQ)和症状感知量表问卷。
非肥胖组 55 例(51.4%),肥胖组 52 例(48.6%)。非肥胖组的中位年龄为 49.0(范围 30.8-73.5)岁,肥胖组为 52.7(范围 35.5-73.5)岁(p>0.05)。肥胖组的 SUI 症状分级、尿道过度活动、尿急和急迫性尿失禁评分均高于非肥胖组(p<0.05)。两组 KHQ 各领域和 3 天频率-容积图表项目均无差异(p>0.05)。术后,肥胖组的症状评分和 3 天频率-容积图表参数与非肥胖组相似(p>0.05)。两组患者术后 1 年客观成功率、复发率和并发症发生率相似(p>0.05)。
肥胖的 SUI 患者的 SUI 症状分级、尿急和急迫性尿失禁症状较非肥胖患者严重。然而,TOT 手术矫正可以有效地恢复肥胖患者的症状和排尿参数。