Hensel G, Koštál M, Göbel J
Department of Obstetrics and Gynaecology, Pardubická krajská nemocnice, a. s., Pardubice, Czech Republic.
Geburtshilfe Frauenheilkd. 2014 Jan;74(1):63-68. doi: 10.1055/s-0033-1351073. Epub 2014 Jan 21.
Suburethral tension-free vaginal tape is used for the treatment of stress urinary incontinence with a high success rate. Often patients report having stress incontinence, as well as co-existing micturition problems which are attributable to overactive bladder syndrome (OAB). The present study examines the effect of suburethral tape on the symptoms of OAB. In the study, we used the transobturator vaginal tape inside-out technique (TVT-O). 53 patients were included in the study, all had proven urodynamic stress incontinence and symptoms of overactive bladder. The patients were examined preoperatively and 3 months after the TVT-O placement. The individual OAB symptoms improved significantly, with urinary frequency and urge incontinence improving more than nocturia. The frequency of micturition decreased on average from 16.1 to 10.1 episodes/24 hours, while nocturnal frequency of micturition decreased from 2.2 to 1.1. Not a single patient experienced the simultaneous worsening of all three measured variables, however 19 % of patients did report their simultaneous disappearance. Their quality of life that had been affected by OAB was measured on the basis of validated questionnaires, and found to have improved significantly. Only 28 % of patients reported a desire for drug treatment of OAB symptoms following tape placement. TVT-O placement leads to a significant improvement of the symptoms of overactive bladder syndrome. Patient quality of life - which was affected by OAB - was also enhanced by the tape placement. This accounts for a substantial share of the overall success of the suburethral tape.
经尿道无张力阴道吊带术用于治疗压力性尿失禁,成功率较高。患者常报告存在压力性尿失禁,以及并存归因于膀胱过度活动症(OAB)的排尿问题。本研究探讨经尿道吊带术对OAB症状的影响。在该研究中,我们采用了经闭孔阴道吊带术(TVT-O)的体内翻技术。53例患者纳入研究,所有患者均经尿动力学证实存在压力性尿失禁及膀胱过度活动症状。对患者在术前及TVT-O置入术后3个月进行检查。个体OAB症状有显著改善,尿频和急迫性尿失禁的改善程度超过夜尿症。排尿频率平均从16.1次/24小时降至10.1次,而夜间排尿频率从2.2次降至1.1次。没有一例患者出现所有三个测量变量同时恶化的情况,然而19%的患者报告这三个变量同时消失。通过经过验证的问卷对受OAB影响的患者生活质量进行评估,发现有显著改善。仅有28%的患者报告在吊带置入术后希望采用药物治疗OAB症状。TVT-O置入术可使膀胱过度活动症症状得到显著改善。受OAB影响的患者生活质量也因吊带置入术而得到提高。这在经尿道吊带术总体成功中占很大比例。