Madhuvrata P, Ford J, Merrick K, Boachie C, Abdel-Fattah M
Department of Obstetrics and Gynaecology, Sheffield Teaching Hospital Foundation Trust, Sheffield, UK.
J Obstet Gynaecol. 2011 Jul;31(5):424-8. doi: 10.3109/01443615.2011.568074.
Voiding dysfunction (VD) is relatively common following suburethral tape insertion. Our study aimed to identify perioperative variables that predict VD. Women who underwent suburethral tapes (TVT(TM) and TVT-O(TM)), either as sole procedure or with a concomitant prolapse repair, were studied retrospectively. The primary outcome was women requiring catheterisation and/or re-catheterisation in the postoperative period. A total of 319 women underwent suburethral tapes within the study period: 256 case notes (80.2%) were available for review and 40/256 women (15.6%) developed postoperative VD. No preoperative urinary symptoms were associated with postoperative VD. Univariate analysis demonstrated three variables associated with VD: average flow rate (Q-ave) ≤5th centile (odds ratio (OR) 2.3, 95% CI 1.2-6.5, p = 0.016), a combination of Q-ave and maximum flow rate (Q-max) ≤5th centile (OR 2.8, 95% CI 1.1-6.9, p = 0.030) and concomitant prolapse procedure (OR 3.6, 95% CI 1.5-8.9, p = 0.005). Following multivariate logistic regression Q-ave ≤5th centile and concomitant prolapse procedure showed the strongest association with VD.
尿道下吊带置入术后排尿功能障碍（VD）较为常见。我们的研究旨在确定预测VD的围手术期变量。对接受尿道下吊带（TVT(TM)和TVT - O(TM)）手术的女性进行了回顾性研究，这些手术要么作为单独手术，要么与脱垂修复术同时进行。主要结局是术后需要导尿和/或再次导尿的女性。在研究期间，共有319名女性接受了尿道下吊带手术：256份病例记录（80.2%）可供审查，40/256名女性（15.6%）出现了术后VD。术前尿路症状与术后VD无关。单因素分析显示与VD相关的三个变量：平均尿流率（Q - ave）≤第5百分位数（比值比（OR）2.3，95%置信区间1.2 - 6.5，p = 0.016）、Q - ave和最大尿流率（Q - max）的组合≤第5百分位数（OR 2.8，95%置信区间1.1 - 6.9，p = 0.030）以及同时进行脱垂手术（OR 3.6，95%置信区间1.5 - 8.9，p = 0.005）。多因素逻辑回归分析后，Q - ave≤第5百分位数和同时进行脱垂手术与VD的关联最为强烈。
