Section of Urology Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
Curr Urol Rep. 2013 Oct;14(5):386-94. doi: 10.1007/s11934-013-0337-6.
The purpose of this review is to review the most current patient reported (subjective) and physician reported (objective) outcomes and adverse events associated with retropubic (RMUS) and transobturator (TMUS) mid-urethral slings. Since the two landmark meta-analyses published in 2010, four new RCT have been published and five have reported long-term outcomes comparing RMUS versus TMUS. Both RMUS and TMUS are safe and have efficacious longer-term outcomes. There is no difference between these slings' subjective outcomes. There is still debate regarding whether RMUS is slightly superior when assessing objective outcomes. Although three trials showed no difference in objective outcomes, results from the largest trial show that RMUS is superior. Further analysis suggests that women with poor urethral function have less favorable outcomes with TMUS and may do better with RMUS. Adverse events are common, and they differ depending on the surgical approach. These new trials confirm previous reported adverse events.
本次综述的目的是回顾与经耻骨后（RMUS）和经闭孔（TMUS）中尿道吊带相关的最新患者报告（主观）和医生报告（客观）结局和不良事件。自 2010 年发表的两项具有里程碑意义的荟萃分析以来，又发表了四项新的 RCT，并报告了五项比较 RMUS 与 TMUS 的长期结局。RMUS 和 TMUS 均安全且具有长期有效的结局。这两种吊带的主观结局没有差异。在评估客观结局时，RMUS 是否略占优势仍存在争议。尽管三项试验在客观结局方面没有差异，但最大规模试验的结果表明 RMUS 更优。进一步的分析表明，尿道功能不佳的女性使用 TMUS 的结局较差，而使用 RMUS 的结局可能更好。不良事件较为常见，且因手术入路而异。这些新试验证实了先前报告的不良事件。
