Maldonado Pedro A, Kogutt Benjamin K, Wai Clifford Y
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Curr Opin Obstet Gynecol. 2014 Oct;26(5):404-8. doi: 10.1097/GCO.0000000000000097.
Patient-reported outcomes and satisfaction are recognized as being equally important as traditional objective measures of success following midurethral sling (MUS) procedures. The objective of this article is to review the success after MUSs in the context of patient satisfaction.
Patient satisfaction for both transobturator and retropubic MUSs at 2 years is high with rates up to 88%. Factors that positively influence satisfaction include improvement in quality of life and reduction in severity of symptoms. Satisfaction has been found to be negatively impacted by persistent stress incontinence, preoperative urinary urgency, mixed urinary incontinence, detrusor overactivity, and selected comorbidities such as diabetes. Factors, such as postoperative incomplete bladder emptying, irritative voiding, and complications after MUS surgery, can also influence satisfaction adversely.
Combining patient-reported outcome measures with customary objective measures offer a more comprehensive assessment of success. Even though the data are limited, the short-term and intermediate-term rates of satisfaction are promising for both transobturator and retropubic MUSs. Future studies should focus on further elucidating long-term predictors of satisfaction after MUS placement.
患者报告的结局和满意度被认为与经尿道中段吊带术(MUS)后传统的客观成功指标同样重要。本文的目的是在患者满意度的背景下回顾MUS术后的成功率。
经闭孔和耻骨后MUS术后2年的患者满意度较高,高达88%。对满意度有积极影响的因素包括生活质量的改善和症状严重程度的减轻。研究发现,持续性压力性尿失禁、术前尿急、混合性尿失禁、逼尿肌过度活动以及某些合并症(如糖尿病)会对满意度产生负面影响。MUS术后膀胱排空不全、刺激性排尿及并发症等因素也会对满意度产生不利影响。
将患者报告的结局指标与传统的客观指标相结合,能更全面地评估手术成功率。尽管数据有限,但经闭孔和耻骨后MUS的短期和中期满意度很有前景。未来的研究应侧重于进一步阐明MUS植入术后满意度的长期预测因素。