Dias Jorge, Xambre Luís, Costa Luís, Costa Pedro, Ferraz Luís
Urology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal,
Int Urogynecol J. 2014 Aug;25(8):1089-95. doi: 10.1007/s00192-014-2355-4. Epub 2014 Mar 6.
Data on Altis® (Coloplast), a new adjustable single-incision sling (SIS) procedure for the treatment of female stress urinary incontinence (SUI), are scarce. Our aim was to evaluate the efficacy and complication rates of this procedure.
In this prospective observational study, a total of 52 women with SUI were implanted with an Altis sling in an ambulatory setting. Before and after intervention (3, 6, and 12 months), women completed the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). In addition, patients underwent a cough stress test at each evaluation and a post-voiding residual urine volume estimation at 3 months. The main outcomes measured were subjective cure (ICIQ-SF = 0), subjective improvement (ICIQ-SF >0 and < preoperative ICIQ-SF), and objective cure (negative cough stress test and no pad usage) rates. De novo overactive bladder (OAB) symptoms, changes in voiding habits and adverse events were also analyzed.
The subjective cure rate at 12 months was 84.0%, with an additional improvement rate of 8.0%. The objective cure rate was 90.2%. Later postoperative complications included 1 case of vaginal extrusion (requiring surgical removal of the eroded mesh segment), 3 cases of vaginal exposure of the adjustment thread (managed conservatively), de novo urgency in 3 patients, and mild dyspareunia in 2 patients.
The Altis sling is a safe and effective SIS procedure for the treatment of SUI with a short-term follow-up.
关于Altis®（康乐保公司产品）这种用于治疗女性压力性尿失禁（SUI）的新型可调节单切口吊带（SIS）手术的数据较少。我们的目的是评估该手术的疗效和并发症发生率。
在这项前瞻性观察研究中，共有52例SUI女性患者在门诊环境中植入了Altis吊带。在干预前以及干预后3个月、6个月和12个月，女性患者完成了国际尿失禁咨询问卷简表（ICIQ-SF）。此外，患者在每次评估时都进行了咳嗽压力测试，并在3个月时进行了排尿后残余尿量估计。主要测量的结果是主观治愈（ICIQ-SF = 0）、主观改善（ICIQ-SF > 0且<术前ICIQ-SF）以及客观治愈（咳嗽压力测试阴性且不使用护垫）率。还分析了新发膀胱过度活动症（OAB）症状、排尿习惯的变化以及不良事件。
12个月时主观治愈率为84.0%，另有改善率为8.0%。客观治愈率为90.2%。术后晚期并发症包括1例阴道挤压（需要手术切除侵蚀的网片段）、3例调节线阴道外露（保守处理）、3例患者出现新发尿急以及2例患者出现轻度性交困难。
对于SUI的治疗，Altis吊带是一种安全有效的SIS手术，随访期较短。
