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经阴道单切口技术对压力性尿失禁患者生活质量的影响。

Effects of single vaginal incision technique on quality of life in women with stress urinary incontinence.

机构信息

Division of Urogynecology, Department of Obstetrics and Gynecology, Zeynep Kamil Women's Hospital, Istanbul, Turkey.

出版信息

J Minim Invasive Gynecol. 2011 Sep-Oct;18(5):634-9. doi: 10.1016/j.jmig.2011.06.007.

Abstract

STUDY OBJECTIVE

To estimate the short-term effects of a minimally invasive single vaginal incision technique without passing through the abdomen or groin (ContaSure Needleless System) on the quality of life in women with incontinence.

DESIGN

Prospective cohort study (Canadian Task Force classification II-2).

SETTING

Tertiary referral urogynecology clinic.

PATIENTS

50 consecutive patients with urodynamically proved stress urinary incontinence from October 2008 to March 2009.

INTERVENTIONS

Preoperative and postoperative scores on the short forms of the IIQ-7 (Incontinence Impact Questionnaire, UDI-6 (Urinary Distress Inventory) PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function), and long form of the P-QOL (Prolapse Quality of Life) were evaluated in 50 patients with urodynamically proved stress urinary incontinence. Scores were compared with postoperative urodynamic findings.

MEASUREMENTS AND MAIN RESULTS

Mean (SD) follow-up was 433.5 (44.1) days (95% CI, 420.1-445.1). Patients showed statistically significant improvement insofar as preoperative and postoperative scores on the IIQ-7, P-QOL, and PISQ-12 and the irritative and stress subgroups of UDI-6. Obstructive score of UDI-6 worsened, consistent with the findings of pressure-flow studies. Postoperatively, 40 patients (80%) were urodynamically continent. Eight patients (16%) were still incontinent; however, their quality of life scores (IIQ-7 and UDI-6 stress) improved. Two patients (4%) continued to experience leakage, with equal or worsened quality-of-life scores.

CONCLUSION

Early clinical results of the present trial demonstrate that the ContaSure Needleless System seems to be capable of improving significantly all aspects of quality of life in women with incontinence. To improve the willingness for treatment of women with stress incontinence, this minimally invasive technique should be encouraged after confirming its efficacy in larger prospective, randomized, comparative trials.

摘要

研究目的

评估一种微创单阴道切口技术(ContaSure 无针系统)对压力性尿失禁患者生活质量的短期影响,该技术无需经腹部或腹股沟。

设计

前瞻性队列研究(加拿大工作队分类 II-2)。

地点

三级转诊尿妇科诊所。

患者

2008 年 10 月至 2009 年 3 月期间,50 例经尿动力学证实的压力性尿失禁患者。

干预措施

对 50 例经尿动力学证实的压力性尿失禁患者进行 IIQ-7(尿失禁影响问卷)短表、UDI-6(尿失禁困扰量表)、PISQ-12(盆腔器官脱垂/尿失禁性功能问卷)和 P-QOL(盆腔器官脱垂生活质量问卷)的短表评分以及 P-QOL(盆腔器官脱垂生活质量问卷)的长表评分进行术前和术后评估。评分与术后尿动力学检查结果进行比较。

测量和主要结果

平均(SD)随访时间为 433.5(44.1)天(95%可信区间,420.1-445.1)。患者的 IIQ-7、P-QOL 和 PISQ-12 以及 UDI-6 的刺激和压力亚组的术前和术后评分均有统计学显著改善。UDI-6 的梗阻评分恶化,与压力-流量研究结果一致。术后,40 例患者(80%)尿动力学上是无失禁的。8 例患者(16%)仍有失禁,但他们的生活质量评分(IIQ-7 和 UDI-6 压力)有所改善。2 例患者(4%)继续有漏尿,但生活质量评分相同或恶化。

结论

本试验的早期临床结果表明,ContaSure 无针系统似乎能够显著改善所有压力性尿失禁患者的生活质量。为了提高压力性尿失禁女性对治疗的意愿,在更大规模的前瞻性、随机、对照试验证实其疗效后,应鼓励使用这种微创技术。

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