Botros Carolyn, Lewis Christa, Culligan Patrick, Salamon Charbel
Division of Urogynecology and Reconstructive Pelvic Surgery, Atlantic Health System, Morristown, NJ, USA.
Int Urogynecol J. 2014 Nov;25(11):1541-6. doi: 10.1007/s00192-014-2432-8. Epub 2014 Jun 4.
The objective of this study was to evaluate the efficacy and safety of the Miniarc Precise® single-incision sling (American Medical Systems, Minnetonka, MN, USA) placed at the time of a robotic sacrocolpopexy.
This was a prospective study of a single-incision suburethral sling placed at the time of robotic sacrocolpopexy in women with stress urinary incontinence (SUI) and pelvic organ prolapse. Primary outcome measure was cure at 1 year, defined objectively by a negative cough stress test (CST) and subjectively by a score of "0 or 1" on question 17 of the Pelvic Floor Distress Inventory (PFDI-20): "Do you experience urine leakage related to coughing/sneezing/laughing?" Secondary outcome measures included the change in Urinary Distress Inventory (UDI-6) and Urinary Impact Questionnaire (UIQ-7) scores at 1 year. All sling-related complications were reported. Paired Student's t test and the Wilcoxon signed-rank test were used for statistical analysis.
One hundred and one patients were included between August 2010 and July 2012. One-year follow-up was available for 97 out of 101 patients (96 %). Objective cure was 90 % and subjective cure was 87 %. Baseline UDI-6 scores improved from 34.8 ± 25.1 to 6.7 ± 11.2 at 1 year (p < 0.001). Similarly, UIQ-7 scores improved from 21.1 ± 22.8 to 2.4 ± 8.2 at 1 year (p < 0.001). There were no intraoperative cystotomies, no mesh erosions, no sling revisions, and no cases of urinary retention. The retreatment rate for persistent SUI was 8 % (8 out of 97).
The addition of a single-incision suburethral sling at the time of robotic sacrocolpopexy in women with SUI resulted in an 87 % cure rate at 1 year.
本研究的目的是评估在机器人骶骨阴道固定术时放置的Miniarc Precise®单切口吊带（美国美敦力公司，明尼通卡，明尼苏达州，美国）的疗效和安全性。
这是一项对患有压力性尿失禁（SUI）和盆腔器官脱垂的女性在机器人骶骨阴道固定术时放置单切口尿道下吊带的前瞻性研究。主要结局指标是1年时的治愈情况，客观上通过阴性咳嗽压力试验（CST）定义，主观上通过盆底困扰量表（PFDI - 20）第17个问题的“0或1”分来定义：“您是否经历过与咳嗽/打喷嚏/大笑相关的漏尿？”次要结局指标包括1年时尿困扰量表（UDI - 6）和尿影响问卷（UIQ - 7）评分的变化。报告了所有与吊带相关的并发症。采用配对学生t检验和Wilcoxon符号秩检验进行统计分析。
2010年8月至2012年7月期间纳入了101例患者。101例患者中有97例（96%）进行了1年的随访。客观治愈率为90%，主观治愈率为87%。1年时，基线UDI - 6评分从34.8±25.1改善至6.7±11.2（p < 0.001）。同样，1年时UIQ - 7评分从21.1±22.8改善至2.4±8.2（p < 0.001）。术中无膀胱切开术，无网片侵蚀，无吊带翻修，无尿潴留病例。持续性SUI的再治疗率为8%（97例中有8例）。
在患有SUI的女性进行机器人骶骨阴道固定术时加用单切口尿道下吊带，1年时治愈率达87%。
