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[单切口可调节迷你吊带Ajust治疗老年女性压力性尿失禁合并晚期盆腔器官脱垂的疗效]

[Efficiency of single incision adjustable mini sling, Ajust, for the treatment of stress urinary incontinence combined with advanced pelvic organ prolapse in eldly women].

作者信息

Jin Haizheng, Lu Yongxian, Shen Wenjie, Liu Xin, Liu Jingxia, Ge Jing, Zhang Yinghui, Qin Lin, Li Rui, Yang Yuhui

机构信息

Department of Obstetrics and Gynecology, First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048, China.

Department of Obstetrics and Gynecology, First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048, China; Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Jun;50(6):409-14.

Abstract

OBJECTIVE

To estimate the efficiency of the single incision adjustable mini sling, Ajust, in the treatment of stress urinary incontinence (SUI) concomitant with advanced pelvic organ prolapse (POP) in eldly women.

METHODS

From Dec. 2013 to Jul. 2014, 58 patients who had been diagnosed as SUI combined with advanced POP underwent both single incision adjustable mini sling and reductive surgery for advanced POP in the First Affiliated Hospital, General Hospital of People's Liberation Army. Fifty-eight patients were assessed to evaluate the safety and efficiency at 2, 6, 12 months postoperatively. The primary outcomes include objective and subjective cure rate, Ajust sling related complications, ralues of urinary distress inventory (UDI-6), incontinence impact questionnaire short form (IIQ-7) and patient global impression of change (PGI-C).

RESULTS

There was no case of leakage tested by cough test, so the objective cure rate for anti-incontinence had been achived to 100% (58/58) at a mean 12 months follow-up. There were 91% (53/58) of the patients' PGI-C score reached 5, and 9% (5/58) of the patients' PGI-C score reached 4. No case underwent the reoperation. There was no case of hematoma, bladder perforation, urethral injury, groin pain, as well as pain in the puncture point during the perioperative period of time. The values of UDI-6 and IIQ-7 declined significantly postoperatively (P < 0.01).

CONCLUSIONS

The single incision mini sling, Ajust, presents satisfactory objective and subjective cure rate in the treatment of mild and moderate SUI combined with severe POP in the eldly womem. The advantages of this mini sling includes mini-invasiveness, simple to use, rare complications and less urinary retention rate. It is a procedure worth recommending in the clinical treatment of mild to moderate SUI.

摘要

目的

评估单切口可调节迷你吊带Ajust治疗老年女性压力性尿失禁(SUI)合并晚期盆腔器官脱垂(POP)的疗效。

方法

2013年12月至2014年7月,58例被诊断为SUI合并晚期POP的患者在解放军总医院第一附属医院接受了单切口可调节迷你吊带手术及晚期POP复位手术。对58例患者在术后2、6、12个月进行评估,以评价安全性和疗效。主要观察指标包括客观和主观治愈率、Ajust吊带相关并发症、尿失禁困扰量表(UDI-6)评分、尿失禁影响问卷简表(IIQ-7)评分及患者总体印象变化(PGI-C)。

结果

咳嗽试验无漏尿病例,平均随访12个月时抗尿失禁客观治愈率达100%(58/58)。91%(53/58)的患者PGI-C评分达到5,9%(5/58)的患者PGI-C评分达到4。无再次手术病例。围手术期无血肿、膀胱穿孔、尿道损伤、腹股沟疼痛及穿刺点疼痛病例。术后UDI-6和IIQ-7评分显著下降(P<0.01)。

结论

单切口迷你吊带Ajust治疗老年女性轻中度SUI合并重度POP的客观和主观治愈率令人满意。该迷你吊带具有微创、使用简单、并发症少及尿潴留率低等优点。是轻中度SUI临床治疗中值得推荐的术式。

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