Pereira Inês, Valentim-Lourenço Alexandre, Castro Catarina, Martins Inês, Henriques Alexandra, Ribeirinho Ana Luísa
Department of Obstetrics, Gynecology, and Reproductive Medicine, Hospital de Santa Maria, Lisbon, Portugal.
, Rua do Ebro N1 4°C, 1990-526, Lisboa, Portugal.
Int Urogynecol J. 2016 Feb;27(2):247-53. doi: 10.1007/s00192-015-2820-8. Epub 2015 Aug 30.
Midurethral slings (MUS) are still discussed in complex incontinence situations, such as obesity, lacking sustained efficacy validation in this particular sub-population. We hypothesized that the outcomes of a transobturator MUS, such as TVT-O, do not differ according to body mass index (BMI) over a 4-year period.
We conducted a retrospective analysis of 281 women who underwent TVT-O at our institution, between 2004 and 2012. Patients were stratified into obese (BMI ≥ 30 kg/m(2)) or non-obese (BMI < 30 kg/m(2)). We compared preoperative and postoperative parameters, including objective cure (negative stress test), complications, and quality of life scores. Data were collected at 0, 6, 12, 24, and 48 months. We used Fisher's exact test for categorical variables and Student's t test or the Mann-Whitney U test for continuous variables.
Baseline characteristics of the obese (n = 122) and non-obese groups (n = 159) were similar. We found no significant differences between groups in terms of objective cure rates at all follow-up evaluations, with 95.8 % and 95 % at 48 months in the non-obese and obese groups respectively. There were no significant differences in the cumulative complication rates of both groups. Quality of life assessment also showed no significant differences between groups at all follow-up visits. At 48 months our follow-up rate was 59 % (n = 96) and 60.4 % (n = 72) in the non-obese and obese group respectively (p = 0.9).
The TVT-O procedure is effective and safe in the long term for stress incontinence treatment, regardless of BMI.
在复杂的尿失禁情况中，如肥胖患者，中段尿道吊带术（MUS）仍存在争议，在这一特定亚组人群中缺乏持续有效的验证。我们假设，经闭孔中段尿道吊带术（如TVT - O）在4年期间的治疗效果不会因体重指数（BMI）的不同而有所差异。
我们对2004年至2012年间在我院接受TVT - O手术的281名女性进行了回顾性分析。患者被分为肥胖组（BMI≥30 kg/m²）和非肥胖组（BMI＜30 kg/m²）。我们比较了术前和术后的参数，包括客观治愈情况（压力试验阴性）、并发症及生活质量评分。数据在0、6、12、24和48个月时收集。分类变量采用Fisher精确检验，连续变量采用Student t检验或Mann - Whitney U检验。
肥胖组（n = 122）和非肥胖组（n = 159）的基线特征相似。在所有随访评估中，两组间的客观治愈率无显著差异，非肥胖组和肥胖组在48个月时的治愈率分别为95.8%和95%。两组的累积并发症发生率也无显著差异。生活质量评估在所有随访中两组间也无显著差异。在48个月时，非肥胖组和肥胖组的随访率分别为59%（n = 96）和60.4%（n = 72）（p = 0.9）。
无论BMI如何，TVT - O手术在长期治疗压力性尿失禁方面都是有效且安全的。
