Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Arch Gynecol Obstet. 2013 May;287(5):959-66. doi: 10.1007/s00404-012-2669-8. Epub 2012 Dec 15.
The objective of this prospective cohort study was to compare effectiveness, morbidity, quality of life (QoL) and sexual function in women treated with tension-free vaginal tape (TVT) versus single-incision sling (SIS) in the treatment of female stress urinary incontinence (SUI).
Retropubic TVT sling or SIS was implanted in local anesthesia and patients were followed post-operatively for 6 months. Evaluation was performed to assess post-operative rate of continence, complications, changes in sexual function and patient reported quality of life. Female sexual function was evaluated before and after sling procedure using Female Sexual Function Index (FSFI) in sexually active patients.
From January 2009 to December 2011, 150 patients were enrolled and underwent a procedure to implant the retropubic TVT (n = 75) or the MiniArc(®) and Ajust(®) SIS (n = 75). Overall, 93.3 % of the patients who successfully received SIS demonstrated total restoration (84 %) or improvement of continence (9.3 %) at the 6 month post-operative study visit. In TVT group we found 88 % total continence and 6.7 % improvement, respectively. Improvements were seen in the QoL scores related to global bladder feeling (89.3 %) in SIS group and 96 % for TVT. Post-operative FSFI score improves significantly and were comparable in both groups (SIS pre-operative 24.30 ± 4.56 to 27.22 ± 4.66 (P < 0.001) post-operative; TVT 24.63 ± 6.62 to 28.47 ± 4.41, respectively).
The SIS procedure appears to be as effective in improving incontinence-related quality of life and sexual function as the TVT through 6 months of post-operative follow-up. No differences in complications and sexual function were demonstrated between the groups.
本前瞻性队列研究旨在比较经阴道无张力吊带（TVT）与单切口吊带（SIS）治疗女性压力性尿失禁（SUI）的有效性、发病率、生活质量（QoL）和性功能。
在局部麻醉下植入经耻骨 TVT 吊带或 SIS，术后随访 6 个月。评估术后尿控率、并发症、性功能变化和患者报告的生活质量。对有性生活的患者，在吊带术前和术后使用女性性功能指数（FSFI）评估女性性功能。
2009 年 1 月至 2011 年 12 月，共纳入 150 例患者，其中 75 例接受经耻骨 TVT 植入术（n=75），75 例接受 MiniArc®和 Ajust®SIS 植入术。总体而言，75 例成功接受 SIS 的患者中，93.3%在术后 6 个月研究访视时完全恢复（84%）或改善尿控（9.3%）。TVT 组分别为 88%和 6.7%。SIS 组与膀胱整体感觉相关的 QoL 评分改善（89.3%），而 TVT 组为 96%。术后 FSFI 评分显著提高，两组之间无差异（SIS 术前 24.30±4.56 至术后 27.22±4.66（P<0.001）；TVT 术前 24.63±6.62 至术后 28.47±4.41）。
SIS 术在改善与尿失禁相关的生活质量和性功能方面与 TVT 相似，在术后 6 个月的随访中。两组之间在并发症和性功能方面没有差异。
