Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
J Urol. 2014 Sep;192(3):856-60. doi: 10.1016/j.juro.2014.04.006. Epub 2014 Apr 13.
Because there is reluctance to operate for pain, we evaluated midterm outcomes of vaginal mesh and synthetic suburethral tape removed for pain as the only indication.
After receiving institutional review board approval we reviewed a prospective database of women without a neurogenic condition who underwent surgery for vaginal mesh or suburethral tape removal with a focus on pain as the single reason for removal and a minimum 6-month followup. The primary outcome was pain level assessed by a visual analog scale (range 0 to 10) at baseline and at each subsequent visit with the score at the last visit used for analysis. Parameters evaluated included demographics, mean time to presentation and type of mesh or tape inserted.
From 2005 to 2013, 123 patients underwent surgical removal of mesh (69) and suburethral tape (54) with pain as the only indication. Mean followup was 35 months (range 6 to 59) in the tape group and 22 months (range 6 to 47) in the mesh group. The visual analog scale score decreased from a mean preoperative level of 7.9 to 0.9 postoperatively (p = 0.0014) in the mesh group and from 5.3 to 1.5 (p = 0.00074) in the tape group. Pain-free status, considered a score of 0, was achieved in 81% of tape and 67% of mesh cases, respectively. No statistically significant difference was found between the groups.
When pain is the only indication for suburethral tape or vaginal mesh removal, a significant decrease in the pain score can be durably expected after removal in most patients at midterm followup.
由于对疼痛存在抵触情绪，我们评估了因疼痛而唯一指征进行阴道网片或合成尿道下吊带移除的中期结果。
在获得机构审查委员会批准后，我们对一组无神经源性疾病的女性进行了前瞻性研究，这些女性因疼痛而行阴道网片或尿道下吊带切除术，其唯一指征是疼痛，且随访时间至少为 6 个月。主要结果是使用最后一次就诊时的视觉模拟评分（范围 0 至 10）评估疼痛水平。评估的参数包括人口统计学特征、就诊的平均时间以及置入的网片或吊带类型。
2005 年至 2013 年，123 例患者因疼痛而唯一指征行手术移除网片（69 例）和尿道下吊带（54 例）。在吊带组中，平均随访时间为 35 个月（范围 6 至 59），在网片组中为 22 个月（范围 6 至 47）。网片组的视觉模拟评分从术前的平均 7.9 分降至术后的 0.9 分（p = 0.0014），吊带组从 5.3 分降至 1.5 分（p = 0.00074）。疼痛缓解状态（评分 0）分别在 81%的吊带和 67%的网片病例中达到。两组之间无统计学差异。
当疼痛是尿道下吊带或阴道网片移除的唯一指征时，在中期随访中，大多数患者在移除后疼痛评分可显著降低，并可持久缓解。
