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一种新型可调节单切口吊带治疗女性压力性尿失禁的安全性和有效性

The safety and efficacy of a new adjustable single incision sling for female stress urinary incontinence.

作者信息

Kocjancic Ervin, Tu Le-Mai, Erickson Ty, Gheiler Edward, Van Drie Douglas

机构信息

University of Illinois at Chicago, Chicago, Illinois.

Hôpital Fleurimont, Sherbrooke, Quebec, Canada.

出版信息

J Urol. 2014 Nov;192(5):1477-82. doi: 10.1016/j.juro.2014.05.101. Epub 2014 Jun 5.

Abstract

PURPOSE

We describe the safety and efficacy of the Altis(®) Single Incision Sling System for the treatment of female stress urinary incontinence through 12 months.

MATERIALS AND METHODS

In this study we collected a variety of safety and efficacy measures relevant to the assessment of urinary incontinence. The primary efficacy end point was improvement in 24-hour pad weight test. Other efficacy measures included the cough stress test, Urogenital Distress Inventory-Short Form, Incontinence Impact Questionnaire-Short Form, Patient Global Impression of Improvement and 3-day voiding diary. Safety was evaluated through assessment of device and procedure related adverse events.

RESULTS

Of 116 surgical attempts 113 subjects were implanted with the Altis sling. Of these patients 103 had primary efficacy data at baseline and 6 months, and 101 had efficacy data at baseline and 12 months. Consequently 88 (85.4%) subjects at 6 months and 91 (90.1%) at 12 months achieved a 50% or greater reduction in pad weight. The cough stress test was negative for 95 (92.2%) subjects at 6 months and 91 (90.1%) at 12 months. A decrease in median leaks per day was observed at 6 months and improvements in all patient reported measures were observed through 12 months. A majority of subjects reported feeling much better or very much better at 6 and 12 months, respectively. There were no reports of mesh erosion or migration and no unanticipated adverse events through 12 months.

CONCLUSIONS

The Altis sling appears to be safe and efficacious, and performs as intended in the treatment of stress urinary incontinence through 12 months.

摘要

目的

我们描述了Altis(®)单切口吊带系统治疗女性压力性尿失禁12个月的安全性和有效性。

材料与方法

在本研究中,我们收集了与尿失禁评估相关的各种安全性和有效性指标。主要疗效终点是24小时护垫重量试验的改善情况。其他疗效指标包括咳嗽压力试验、泌尿生殖系统困扰量表简表、尿失禁影响问卷简表、患者总体改善印象和3天排尿日记。通过评估与器械和手术相关的不良事件来评价安全性。

结果

在116次手术尝试中,113名受试者植入了Altis吊带。其中103名患者在基线和6个月时有主要疗效数据,101名患者在基线和12个月时有疗效数据。因此,88名(85.4%)受试者在6个月时护垫重量减少了50%或更多,91名(90.1%)受试者在12个月时护垫重量减少了50%或更多。咳嗽压力试验在6个月时95名(92.2%)受试者为阴性,在12个月时91名(90.1%)受试者为阴性。在6个月时观察到每日漏尿中位数减少,并且在12个月内观察到所有患者报告指标均有改善。大多数受试者分别报告在6个月和12个月时感觉好多了或非常好多了。在12个月内没有网状物侵蚀或移位的报告,也没有意外不良事件的报告。

结论

Altis吊带似乎是安全有效的,并且在治疗压力性尿失禁12个月时按预期发挥作用。

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