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术前排尿逼尿肌压力不能预测压力性尿失禁手术的结果。

Preoperative voiding detrusor pressures do not predict stress incontinence surgery outcomes.

作者信息

Kirby Anna C, Nager Charles W, Litman Heather J, FitzGerald Mary P, Kraus Stephen, Norton Peggy, Sirls Larry, Rickey Leslie, Wilson Tracey, Dandreo Kimberly J, Shepherd Jonathan P, Zimmern Philippe

机构信息

Reproductive Medicine, University of California San Diego, San Diego, CA, USA.

出版信息

Int Urogynecol J. 2011 Jun;22(6):657-63. doi: 10.1007/s00192-010-1336-5. Epub 2010 Dec 10.

DOI:10.1007/s00192-010-1336-5
PMID:21153471
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3097343/
Abstract

INTRODUCTION AND HYPOTHESIS

The aim of this study was to determine whether preoperative voiding detrusor pressures were associated with postoperative outcomes after stress incontinence surgery.

METHODS

Opening detrusor pressure, detrusor pressure at maximum flow (p (det) Q(max)), and closing detrusor pressure were assessed from 280 valid preoperative urodynamic studies in subjects without advanced prolapse from a multicenter randomized trial comparing Burch and autologous fascia sling procedures. These pressures were compared between subjects with and without overall success, stress-specific success, postoperative detrusor overactivity, and postoperative urge incontinence using independent sample t tests.

RESULTS

There were no clinically or statistically significant differences in mean preoperative voiding detrusor pressures in any comparison of postoperative outcomes.

CONCLUSIONS

We found no evidence that preoperative voiding detrusor pressures predict outcomes in women with stress predominant urinary incontinence undergoing Burch or autologous fascial sling procedures.

摘要

引言与假设

本研究旨在确定压力性尿失禁手术后，术前排尿逼尿肌压力是否与术后结果相关。

方法

从一项多中心随机试验中280例有效的术前尿动力学研究中评估起始逼尿肌压力、最大尿流率时的逼尿肌压力（p(det)Q(max)）和排尿末逼尿肌压力，该试验比较了Burch手术和自体筋膜吊带手术，研究对象为无重度脏器脱垂的患者。使用独立样本t检验比较有和没有总体成功、压力性尿失禁特异性成功、术后逼尿肌过度活动和术后急迫性尿失禁的患者之间的这些压力。

结果

在任何术后结果的比较中，术前平均排尿逼尿肌压力均无临床或统计学上的显著差异。

结论

我们没有发现证据表明，术前排尿逼尿肌压力可预测接受Burch手术或自体筋膜吊带手术的以压力性尿失禁为主的女性患者的手术结果。

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Comment on Kirby et al.: Preoperative voiding detrusor pressures do not predict stress incontinence surgery outcomes.关于柯比等人的评论：术前排尿逼尿肌压力不能预测压力性尿失禁手术结果。
Int Urogynecol J. 2012 Mar;23(3):379-80; author reply 381-2. doi: 10.1007/s00192-011-1576-z. Epub 2011 Dec 1.

本文引用的文献

1
Mixed incontinence: comparing definitions in women having stress incontinence surgery.混合性尿失禁：比较接受压力性尿失禁手术的女性的定义
Neurourol Urodyn. 2009;28(4):268-73. doi: 10.1002/nau.20698.
2
Pre-operative opening detrusor pressure is predictive of detrusor overactivity following TVT in patients with pre-operative mixed urinary incontinence.术前开放逼尿肌压力可预测术前混合性尿失禁患者经阴道无张力尿道中段吊带术（TVT）后逼尿肌过度活动。
Neurourol Urodyn. 2009;28(1):82-5. doi: 10.1002/nau.20576.
3
Two-year outcomes after surgery for stress urinary incontinence in older compared with younger women.老年女性与年轻女性压力性尿失禁手术后的两年结局
Obstet Gynecol. 2008 Sep;112(3):621-9. doi: 10.1097/AOG.0b013e31818187c2.
4
Urodynamic measures do not predict stress continence outcomes after surgery for stress urinary incontinence in selected women.尿动力学检测无法预测特定女性压力性尿失禁手术后的压力性尿失禁治疗效果。
J Urol. 2008 Apr;179(4):1470-4. doi: 10.1016/j.juro.2007.11.077. Epub 2008 Mar 4.
5
Predictors of treatment failure 24 months after surgery for stress urinary incontinence.压力性尿失禁手术后24个月治疗失败的预测因素。
J Urol. 2008 Mar;179(3):1024-30. doi: 10.1016/j.juro.2007.10.074. Epub 2008 Jan 18.
6
Burch colposuspension versus fascial sling to reduce urinary stress incontinence.Burch阴道悬吊术与筋膜吊带术治疗压力性尿失禁的比较
N Engl J Med. 2007 May 24;356(21):2143-55. doi: 10.1056/NEJMoa070416. Epub 2007 May 21.
7
Reference urodynamic values for stress incontinent women.压力性尿失禁女性的尿动力学参考值。
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Process for development of multicenter urodynamic studies.多中心尿动力学研究的开展流程。
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