Sirls Larry T, Tennstedt Sharon, Lukacz Emily, Rickey Leslie, Kraus Stephen R, Markland Alayne D, Kenton Kimberly, Moalli Pam, Hsu Yvonne, Huang Liyuan, Stoddard Anne M
Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA.
Female Pelvic Med Reconstr Surg. 2012 Sep-Oct;18(5):291-5. doi: 10.1097/SPV.0b013e318267c004.
To compare quality of life (QoL) and factors associated with QoL change after retropubic (RMUS) and transobturator midurethral slings (TMUS) using the Incontinence Impact Questionnaire (IIQ) and the International Consultation on Incontinence Questionnaire (ICIQ).
Five hundred ninety-seven women in a multicenter randomized trial of RMUS versus TMUS were examined. The IIQ and the ICIQ were obtained at baseline and at 12 and 24 months. Repeated-measures analysis of variance tested for differences by treatment group over time. Multivariable analysis identified factors associated with QoL change at 12 months postoperative, controlling for treatment group and baseline QoL.
Improvement in IIQ was associated with the following: treatment success, younger age, improvement in stress urinary incontinence (SUI) symptom severity, and bother (all P < 0.05). Improvement in ICIQ was associated with treatment success, younger age, improvement in SUI symptom severity and bother, lower body mass index, and no reoperation (all P < 0.05). Improvement of the IIQ was stable over time (P = 0.35) for both treatment groups (P = 0.66), whereas the ICIQ showed a small but clinically insignificant decline (P = 0.03) in both treatment groups (P = 0.51).
Postoperative QoL was improved after RMUS and TMUS. Measures of QoL functioned similarly, although more surgically modifiable urinary incontinence factors predicted improvement with the IIQ.
使用尿失禁影响问卷（IIQ）和国际尿失禁咨询问卷（ICIQ）比较耻骨后中段尿道悬吊术（RMUS）和经闭孔中段尿道悬吊术（TMUS）后生活质量（QoL）及与QoL变化相关的因素。
对597名参与RMUS与TMUS多中心随机试验的女性进行检查。在基线、12个月和24个月时获取IIQ和ICIQ。重复测量方差分析检验治疗组随时间的差异。多变量分析确定术后12个月时与QoL变化相关的因素，同时控制治疗组和基线QoL。
IIQ的改善与以下因素相关：治疗成功、年龄较小、压力性尿失禁（SUI）症状严重程度改善以及困扰程度减轻（所有P<0.05）。ICIQ的改善与治疗成功、年龄较小、SUI症状严重程度和困扰程度改善、较低的体重指数以及未再次手术相关（所有P<0.05）。两个治疗组的IIQ改善随时间保持稳定（P=0.35）（P=0.66），而两个治疗组的ICIQ均显示有小幅但临床上无显著意义的下降（P=0.03）（P=0.51）。
RMUS和TMUS术后QoL得到改善。QoL测量指标作用相似，尽管更多可通过手术改变的尿失禁因素预测IIQ改善情况。
