Yoo Eun-Hee, Kim Donguk
Department of Obstetrics and Gynecology, Kung Hee University Hospital at Gangdong, Kyung Hee University Medical College, Sang-Il Dong, Gangdong-Gu, Seoul 134-727, Korea.
Int Urogynecol J. 2013 Mar;24(3):401-6. doi: 10.1007/s00192-012-1880-2. Epub 2012 Jul 14.
The study sought to identify the risk factors of postoperative use of antimuscarinics after transobturator surgery in women with mixed urinary incontinence (MUI) displaying both urodynamic stress urinary incontinence (SUI) and involuntary detrusor contraction (IDC) with leakage in urodynamic study.
The clinical data of 103 patients with MUI who underwent transobturator tape (TOT) sling surgery were retrospectively reviewed. The patients were followed at least a year. To determine risk factors for postoperative use of antimuscarinics, variables of only those with P values < 0.05 on univariate analysis were included in the multivariate logistic regression analysis with forward stepwise building.
Eight-four (81.6 %) of 103 patients were included in this study. The cure rate of urge urinary incontinence (UUI) was 69.0 % (58/84). Antimuscarinics were prescribed postoperatively in 22 (26.2 %) of 84 patients. Variables affecting postoperative use of antimuscarinics were age, parity, episode of any UUI, preoperative use of antimuscarinics, predominant urgency incontinence type, detrusor pressure at maximum flow, and Urogenital Distress Inventory 6. Increasing age and preoperative use of antimuscarinics increased the odds of postoperative use of antimuscarinics following TOT surgery.
Patients who were older and had taken antimuscarinics preoperatively were significantly associated with postoperative use of antimuscarinics.
本研究旨在确定混合性尿失禁（MUI）女性患者经闭孔手术术后使用抗胆碱能药物的风险因素，这些患者在尿动力学检查中表现为尿动力学压力性尿失禁（SUI）和不自主逼尿肌收缩（IDC）并伴有漏尿。
回顾性分析103例接受经闭孔吊带（TOT）手术的MUI患者的临床资料。对患者进行了至少一年的随访。为确定术后使用抗胆碱能药物的风险因素，单因素分析中P值<0.05的变量被纳入向前逐步构建的多因素逻辑回归分析。
103例患者中有84例（81.6%）纳入本研究。急迫性尿失禁（UUI）的治愈率为69.0%（58/84）。84例患者中有22例（26.2%）术后使用了抗胆碱能药物。影响术后使用抗胆碱能药物的变量包括年龄、产次、任何UUI发作、术前使用抗胆碱能药物、主要急迫性尿失禁类型、最大尿流率时的逼尿肌压力以及泌尿生殖系统困扰量表6。年龄增加和术前使用抗胆碱能药物会增加TOT手术后术后使用抗胆碱能药物的几率。
年龄较大且术前使用过抗胆碱能药物的患者与术后使用抗胆碱能药物显著相关。
