Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Neurourol Urodyn. 2011 Nov;30(8):1609-12. doi: 10.1002/nau.21111. Epub 2011 Jul 20.
The outcome of surgery for stress urinary incontinence (SUI) can be unpredictable. Urethral pressure measurements, including measurement of maximum urethral closure pressure (MUCP) can form part of the investigation of women prior to SUI surgery and some studies have suggested that women with higher MUCP may have a better surgical outcome. This study aims to determine whether outcome of SUI surgery is related to pre-operative MUCP.
All patients undergoing colposuspension or TVT in a large European city between 1998 and 2002 were included. All women underwent pre-operative urodynamics, including measurement of urethral pressure profile; urodynamic data, including MUCP, were determined. Surgical outcome was measured using the ICIQ-FLUTS questionnaire, which was mailed to allow for a minimum follow-up period of 3 years. Surgical outcome was measured by assigning patients to one of three post-operative Stress Urinary Incontinence (SUI) groups. Group 1 (No incontinence), Group 2 (< 1 incontinence episode per day), Group 3 (> 1 incontinence episode per day). Independent statistical analysis was undertaken using STATA® software and a two-way ANOVA (Analysis of Variance) test to determine the relationship between pre-operative MUCP and post-operative SUI group.
A total of 463 postal questionnaires were mailed, with a response rate of 62%, allowing for those who had died or moved away. Of the 285 responders, 218 had undergone colposuspension and 66 had a TVT. Median age, length of follow up and MUCP were 54 years (range 23-81), 77 months (range 47 to 107) and 45 cmH(2) O (range 5 to 105) respectively. Difference in MUCP between the two operation groups (colposuspension and TVT) was not significant (p > 0.19). No significant difference in preoperative MUCP was demonstrated between the three SUI groups, with mean MUCP in the three SUI groups of 50, 45 and 43 cmH(2) 0 respectively, confirming that patients with higher MUCP were not more likely to be in a lower post-operative SUI group (F(2, 237) = 3.42, p < 0.04).
Our data demonstrate that women with higher preoperative MUCP do not have a better surgical outcome following stress incontinence surgery.
压力性尿失禁（SUI）手术的结果可能无法预测。尿道压力测量，包括最大尿道闭合压（MUCP）的测量，可以作为 SUI 手术前女性检查的一部分，一些研究表明，MUCP 较高的女性手术结果可能更好。本研究旨在确定 SUI 手术的结果是否与术前 MUCP 相关。
本研究纳入了 1998 年至 2002 年间在一个欧洲大城市接受耻骨后悬吊术或 TVT 的所有患者。所有女性均接受术前尿动力学检查，包括尿道压力描记；尿动力学数据，包括 MUCP，也已确定。手术结果通过 ICIQ-FLUTS 问卷进行测量，该问卷通过邮寄方式进行，以确保至少 3 年的随访期。手术结果通过将患者分配到三个术后压力性尿失禁（SUI）组之一来测量。第 1 组（无失禁）、第 2 组（<每天 1 次尿失禁发作）、第 3 组（>每天 1 次尿失禁发作）。使用 STATA®软件进行独立的统计分析，并进行双向方差分析（方差分析）测试，以确定术前 MUCP 与术后 SUI 组之间的关系。
共邮寄了 463 份邮政问卷，回复率为 62%，允许那些已经死亡或搬离的人回复。在 285 名应答者中，218 人接受了耻骨后悬吊术，66 人接受了 TVT。中位年龄、随访时间和 MUCP 分别为 54 岁（23-81 岁）、77 个月（47-107 个月）和 45 cmH2O（5-105 cmH2O）。两种手术组（耻骨后悬吊术和 TVT）之间的 MUCP 差异无统计学意义（p>0.19）。三个 SUI 组之间术前 MUCP 无显著差异，三组 SUI 的平均 MUCP 分别为 50、45 和 43 cmH20，证实 MUCP 较高的患者不太可能处于较低的术后 SUI 组（F（2,237）=3.42，p<0.04）。
我们的数据表明，术前 MUCP 较高的女性在压力性尿失禁手术后的手术结果并没有更好。
