Kuribayashi Masato, Kitagawa Yasuhide, Narimoto Kazutaka, Urata Satoko, Kawaguchi Shohei, Namiki Mikio
Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, 920-8640 Takaramachi 13-1, Kanazawa, Ishikawa, Japan.
Int Urogynecol J. 2013 Mar;24(3):407-11. doi: 10.1007/s00192-012-1882-0. Epub 2012 Jul 17.
The purpose of this study was to evaluate the predictors of de novo stress urinary incontinence (SUI) in patients undergoing a tension-free vaginal mesh procedure (TVM) for pelvic organ prolapse (POP).
Sixty-five patients without SUI were assessed with regard to voiding function by a pressure flow study and clinical characteristics.
The mean age of the patients was 67 ± 8.3. Of the 65 patients, 41 (63 %) maintained urinary continence postoperatively and 24 (37 %) showed de novo SUI. In univariate analysis, the de novo SUI group included a significantly higher proportion of patients with preoperative obstruction, defined as moderate or greater obstruction according to the Blaivas nomogram (29 vs 7 %, P = 0.035). In multivariate analysis, urethral obstruction was an independent predictor of de novo SUI with an odds ratio of 12.616 (95 % confidence interval 1.580-268.731).
Preoperative evaluation of urethral obstruction will contribute to prediction of de novo SUI combined with a conventional diagnosis of occult SUI.
本研究旨在评估接受盆腔器官脱垂（POP）无张力阴道网片手术（TVM）患者新发压力性尿失禁（SUI）的预测因素。
对65例无SUI患者进行压力流率研究及临床特征评估以了解排尿功能。
患者平均年龄为67±8.3岁。65例患者中，41例（63%）术后保持尿失禁，24例（37%）出现新发SUI。单因素分析中，新发SUI组术前梗阻患者比例显著更高，根据布莱瓦斯列线图定义为中度或更严重梗阻（29%对7%，P = 0.035）。多因素分析中，尿道梗阻是新发SUI的独立预测因素，比值比为12.616（95%置信区间1.580 - 268.731）。
术前评估尿道梗阻将有助于结合隐匿性SUI的传统诊断预测新发SUI。
