Department of Urology, University of Trieste, Trieste, Italy.
Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):350-3. doi: 10.1016/j.ejogrb.2011.06.012. Epub 2011 Jul 8.
The long-term efficacy of pubovaginal sling (PVS) procedure with porcine small intestinal submucosa (SIS) implant was retrospectively assessed.
Forty-eight patients with SUI underwent a pubovaginal sling with SIS. Patient evaluation included history, physical examination with stress test and prolapse assessment by Baden-Walker classification, routine laboratory tests, 24h-pad test, and multichannel urodynamic measurement. Postoperatively the patients were classified as cured, improved and unchanged or failed. A King's Health Questionnaire (KHQ) was performed to verify post-operatively the quality of life of these patients.
At median follow-up of 76 months 33/48 (69%) were cured, 6/48 (12%) were improved while 9/48 (19%) were failed or unchanged. No urinary retention or dyspareunia was reported and no vaginal erosion or adverse tissue reaction was detected. The descriptive statistics of KHQ scores by dimensions was done in 32/48 patients (67%). Failed or unchanged patients showed worse scores than cured and improved patients in all KHQ dimensions showing an overall overlapping between objective and subjective results although these findings are weakened due to the lack of a preoperative evaluation of QoL.
PVS procedure using SIS cannot offer a durable option for the treatment of SUI as reported by the current mininvasive techniques.
回顾性评估猪小肠黏膜下层（SIS）植入式耻骨膀胱悬吊带（PVS）手术的长期疗效。
48 例压力性尿失禁（SUI）患者接受了 PVS 加 SIS 手术。患者评估包括病史、体格检查（压力测试和脱垂评估采用 Baden-Walker 分级）、常规实验室检查、24 小时垫试验和多通道尿动力学测量。术后将患者分为治愈、改善、不变或失败。采用 King's 健康问卷（KHQ）评估这些患者术后的生活质量。
中位随访 76 个月时，33/48（69%）例治愈，6/48（12%）例改善，9/48（19%）例失败或不变。无尿潴留或性交困难，未发现阴道侵蚀或不良组织反应。对 32/48 例（67%）患者进行了 KHQ 评分维度的描述性统计分析。失败或不变的患者在所有 KHQ 维度上的评分均较治愈和改善的患者差，尽管由于缺乏术前 QoL 评估，这些发现因整体重叠而减弱，但客观和主观结果之间存在总体重叠。
与当前微创技术报道的结果一致，SIS 植入式 PVS 手术不能为 SUI 治疗提供持久的选择。
