Sottner O, Halaška M, Vláčil J, Maxová K, Malá I, Krombholz R, Halaška Mj
Gynekologicko-porodnická klinica 1. LF UK a Nemocnice Na Bulovce prednosta prof. MUDr. M. Halaska, DrSc.
Ceska Gynekol. 2012 Oct;77(5):403-7.
Comparison of different types of tension free tapes in the treatment of urinary incontinence in institutionalized elderly patients.
Prospective randomized study.
Charles University in Prague, 1st Medical Faculty and Hospital Bulovka, Department of Obstetrics and Gynaecology, Prague.
43 patients of several gerontologic centres with prevailing stress urinary incontinence were included based on urinary dysfunction specific questionnaire (ICIQ) and cognitive functions objective estimation (MMSE). Three types of tapes, TVT-O, MiniArc and Ajust were used and patients were randomized into the groups and after an urogynaecologic examination, incl. ultrasound the operation was performed.
The groups were - except of the age of the patients of group MiniArc - well outweighted concerning demographic parameters. High success rate of all techniques used evaluated by the QoL questionnaires was in all the groups comparable. No case of bleeding, bladder injury or postoperative pain was found. Higher frequency of OAB de novo and worsening of preexisting symptomatics could be explained by general very high prevalence of OAB in the elderly even without the operation. In whole our cohort only 1 case of failure to treat and of tape exposure was found. Our results confirming high success rate of all the types also in elderly and institutionalized patients are in consent with sporadic published data.
Surgical treatment of cases of stress and mixed urinary incontinence is also in cases of elderly polymorbid nurcing facilities clients with regard to the high success rate. Secondary outcome of our report when accepting the conclusion is drop of the costs of antiincontinence pads thus having a significant economic effect.
比较不同类型无张力吊带治疗机构养老老年患者尿失禁的效果。
前瞻性随机研究。
布拉格查理大学第一医学院及布洛夫卡医院妇产科，布拉格。
基于尿功能障碍特异性问卷（ICIQ）和认知功能客观评估（MMSE），纳入来自多个老年医学中心的43例以压力性尿失禁为主的患者。使用三种类型的吊带，即经闭孔无张力尿道中段吊带（TVT - O）、MiniArc和Ajust，将患者随机分组，经泌尿妇科检查，包括超声检查后进行手术。
除MiniArc组患者年龄外，各研究组在人口统计学参数方面具有良好的均衡性。通过生活质量问卷评估，所有使用的技术在各研究组中的成功率都相当高。未发现出血、膀胱损伤或术后疼痛的病例。新发膀胱过度活动症（OAB）频率较高以及原有症状加重，可能是由于即使未手术，老年人群中OAB的总体患病率也非常高。在我们的整个队列中，仅发现1例治疗失败和1例吊带暴露病例。我们的结果证实了所有类型的吊带在老年和机构养老患者中也具有很高的成功率，这与零星发表的数据一致。
鉴于手术成功率高，对于患有多种疾病的老年机构养老患者，压力性和混合性尿失禁病例的手术治疗也是可行的。接受该结论时，我们报告的次要结果是尿失禁垫成本降低，从而产生显著的经济效应。
