Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Monoblocco Ospedaliero, IV Floor, Via Giustiniani 2, Padua, Italy.
World J Urol. 2012 Aug;30(4):465-70. doi: 10.1007/s00345-011-0781-1. Epub 2011 Oct 15.
To summarize the available evidence concerning efficacy and safety of standard mid-urethral sling (SMUS) operations for the treatment of stress urinary incontinence (SUI).
A non-systematic literature review was carried out in order to collect the available evidence concerning efficacy and safety of SMUS operations for the treatment of SUI. According to the data of our prior meta-analysis, patients receiving SMUS had significantly higher overall and objective cure rates than those receiving Burch colposuspension, although they had a higher risk of bladder perforations. Patients undergoing SMUS and pubovaginal slings had similar cure rates, although the latter were slightly more likely to experience storage lower urinary tract symptoms and had a higher reoperation rate. Patients treated with retropubic SMUS had slightly higher objective cure rates than those treated with transobturator tape (TOT); however, subjective cure rates were similar, and patients treated with TOT had a much lower risk of some complications. Meta-analysis demonstrated similar outcomes for TOTs. With regard to the novel mini-sling, another meta-analysis from Abdel-fattah et al. demonstrated that repeat continence surgery and de novo urgency incontinence were significantly higher in the patients treated with mini-slings.
Patients treated with retropubic tape (RT) experienced slightly higher continence rates than those treated with Burch colposuspension, but they faced a much higher risk of intraoperative complications. RT and pubovaginal slings were similarly effective. The use of RT was followed by objective cure rates slightly higher than TOT and by higher risk of complications. The novel mini-slings do not seem to be more effective than the SMUS.
总结标准中尿道吊带（SMUS）手术治疗压力性尿失禁（SUI）的疗效和安全性的现有证据。
为了收集有关 SMUS 手术治疗 SUI 的疗效和安全性的现有证据，进行了非系统性文献回顾。根据我们之前的荟萃分析数据，接受 SMUS 治疗的患者总体治愈率和客观治愈率明显高于接受 Burch 耻骨悬吊带术的患者，尽管他们发生膀胱穿孔的风险较高。接受 SMUS 和耻骨阴道吊带术的患者治愈率相似，尽管后者发生储尿期下尿路症状的可能性略高，且再次手术率较高。接受经耻骨后 SMUS 治疗的患者客观治愈率略高于接受经闭孔吊带（TOT）治疗的患者；然而，主观治愈率相似，且接受 TOT 治疗的患者发生某些并发症的风险要低得多。荟萃分析表明 TOT 的结果相似。关于新型迷你吊带，Abdel-fattah 等人的另一项荟萃分析表明，接受迷你吊带治疗的患者再次进行控尿手术和新发急迫性尿失禁的比例明显更高。
接受经耻骨后吊带（RT）治疗的患者的控尿率略高于接受 Burch 耻骨悬吊带术的患者，但术中并发症的风险高得多。RT 和耻骨阴道吊带同样有效。RT 的使用后客观治愈率略高于 TOT，且并发症风险更高。新型迷你吊带似乎并不比 SMUS 更有效。
