Ciftci Seyfettin, Ozkurkcugil Cuneyd, Ustuner Murat, Yilmaz Hasan, Yavuz Ufuk, Gulecen Turgay
Department of Urology, School of Medicine, University of Kocaeli, Kocaeli, Turkey.
Department of Urology, Hakkari State Hospital, Hakkari, Turkey.
Urol J. 2015 Apr 29;12(2):2090-4.
To compare the complications and success rates of hand-made sling with commercial sling used in transobturator tape (TOT) surgery.
From 2008 to 2010, hand-made slings were used in TOT surgery, whereas commercial slings were used from 2010 to 2013 in our clinic. Overall 102 patients were included in the study. Patients were categorized into 2 groups: group 1 had hand-made (polypropylene monofilament) slings, while group 2 had commercial slings (polypropylene monofilament). We retrospectively reviewed 1-year follow-up results of the whole cohort. Ages, body mass indexes, menopausal status, operation time, cost of sling, success of operation and complications were recorded. All these data were compared between the 2 groups.
There were 41 patients (54.29 ± 9.88 years) in group 1 and 61 patients (52.82 ± 9.85 years) in group 2. Menopausal status and body mass index (28.1 vs. 29.2 kg/m² respectively) were similar for both groups. Previous history of incontinence or pelvic organ prolapse surgery (P = .046), mean duration of the procedure (P = .001), and vaginal extrusion rate (P = .016) were significantly lower in group 2. The cost of the sling was higher in group 2 than in group 1. There was no significant difference in success of operation between the groups (P = .319).
According to our results, hand-made mesh is a viable option in TOT surgery with similar efficacy, but surgeons should be careful in terms of vaginal extrusion.
比较经闭孔尿道中段悬吊带术(TOT)中使用自制吊带与商用吊带的并发症及成功率。
2008年至2010年,我们在TOT手术中使用自制吊带,而在2010年至2013年使用商用吊带。本研究共纳入102例患者。患者分为两组:第1组使用自制(聚丙烯单丝)吊带,第2组使用商用吊带(聚丙烯单丝)。我们回顾性分析了整个队列的1年随访结果。记录患者的年龄、体重指数、绝经状态、手术时间、吊带费用、手术成功率及并发症情况。对两组的所有这些数据进行比较。
第1组有41例患者(年龄54.29±9.88岁),第2组有61例患者(年龄52.82±9.85岁)。两组的绝经状态和体重指数(分别为28.1与29.2kg/m²)相似。第2组患者的既往尿失禁或盆腔器官脱垂手术史(P = 0.046)、平均手术时间(P = 0.001)及阴道挤压率(P = 0.016)显著更低。第2组吊带的费用高于第1组。两组间手术成功率无显著差异(P = 0.319)。
根据我们的结果,在TOT手术中自制网片是一种疗效相似的可行选择,但外科医生在阴道挤压方面应谨慎。