Yonguc Tarik, Gunlusoy Bulent, Arslan Burak, Bozkurt Ibrahim Halil, Kozacioglu Zafer, Degirmenci Tansu, Koras Omer
Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey,
Int Urogynecol J. 2014 Oct;25(10):1419-23. doi: 10.1007/s00192-014-2392-z. Epub 2014 Apr 26.
Little information is available on the effects of concomitant vaginal prolapse repair on the outcomes of the transobturator tape (TOT) procedure. The purpose of this study is to assess the results and complications of TOT when combined with vaginal prolapse repair with a long-term follow-up.
We conducted a retrospective cohort study of 232 female patients who underwent the TOT procedure at two institutions. There were two groups: group 1 consisted of patients who had undergone TOT alone and group 2 consisted of patients who had undergone concomitant vaginal prolapse repair. The outcomes were analyzed considering four postoperative parameters: objective cure, subjective cure, resolution of urgency urinary incontinence (UUI), and patient satisfaction. The mean follow-up was 66.3 months (range 60-85).
A total of 117 patients in group 1 and 104 patients in group 2 were documented in this study. The subjective and objective cure rates were 87.17%, 64.95% in group 1 and 89.42%, 68.26% in group 2. Patient satisfaction rates (visual analog scale [VAS] score ≥80) were 71.79 and 83.65% in groups 1 and 2 respectively (p = 0.035). Complications were reported according to the Clavien-Dindo classification with grade I 7.7%, grade II 69.2%, grade IIIa 7.7%, and grade IIIb 15.4%, and grade I 9.5%, grade II 47.6%, grade IIIa 42.8%, and grade IIIb 0% in groups 1 and 2 respectively.
Concomitant vaginal prolapse repair with TOT does not have any negative effects on continence outcomes; on the contrary, it increases patient satisfaction.
关于同时进行阴道脱垂修复术对经闭孔尿道中段吊带术（TOT）手术效果的影响，目前可用信息较少。本研究的目的是评估TOT联合阴道脱垂修复术的结果及并发症，并进行长期随访。
我们对在两家机构接受TOT手术的232例女性患者进行了一项回顾性队列研究。分为两组：第1组为仅接受TOT手术的患者，第2组为同时接受阴道脱垂修复术的患者。根据四个术后参数分析结果：客观治愈、主观治愈、急迫性尿失禁（UUI）缓解及患者满意度。平均随访时间为66.3个月（范围60 - 85个月）。
本研究记录了第1组的117例患者和第2组的104例患者。第1组的主观和客观治愈率分别为87.17%、64.95%，第2组分别为89.42%、68.26%。第1组和第2组的患者满意度（视觉模拟量表[VAS]评分≥80）分别为71.79%和83.65%（p = 0.035）。根据Clavien - Dindo分类报告并发症，第1组I级为7.7%，II级为69.2%，IIIa级为7.7%，IIIb级为15.4%；第2组I级为9.5%，II级为47.6%，IIIa级为42.8%，IIIb级为0%。
TOT联合阴道脱垂修复术对控尿结果没有负面影响；相反，它提高了患者满意度。
