Yonguc Tarik, Bozkurt Ibrahim Halil, Sen Volkan, Aydogdu Ozgu, Yonguc Goksin Nilufer, Gunlusoy Bulent
Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Anatomy, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Int Urol Nephrol. 2015 Oct;47(10):1611-7. doi: 10.1007/s11255-015-1085-y. Epub 2015 Sep 2.
To assess the safety, efficacy of double-sling procedure (DS) for the surgical management of stress urinary incontinence (SUI) with concomitant anterior wall prolapse (AVWP) and to identify if less synthetic material implantation will decrease the complication rates without decreasing the high cure rates.
We reviewed the women who underwent DS in two institutions from January 2009 to December 2013. In DS, there are two transobturator tapes inserted from two different routes for the surgical management of SUI with concomitant AVWP. POP-Q was used for anatomical evaluation of prolapse. SUI was assessed by cough stress test and ICIQ-SF questionnaire. We accepted that the patient was satisfied if the visual analog scale score was ≥80. The severity of urinary incontinence was classified by ICIQ-SF. The women were evaluated at the 3 and 12 months and annually.
A total of 74 women met the requirements for inclusion and had sufficient records for analysis. The mean follow-up period was 35.4 months (range 12-60). Operative time was 33.2 ± 6.2. The objective cure and subjective success rates of SUI were 87.8 and 93.2 %, respectively. The satisfaction from the surgery was also high with 86.5 % rate. The anatomical success in our series was rather high with 96 % rate. Our overall complication rate was 12.2 %. Mesh extrusion rate was 0 %.
Double-sling procedure is feasible, efficient, and safe. Reducing the mesh size did not have a detrimental effect on the outcomes of SUI treatment and simultaneous AVWP repair.
评估双吊带手术（DS）治疗压力性尿失禁（SUI）合并前壁脱垂（AVWP）的安全性和有效性，并确定减少合成材料植入量是否会在不降低高治愈率的情况下降低并发症发生率。
我们回顾了2009年1月至2013年12月在两家机构接受DS手术的女性患者。在DS手术中，通过两条不同路径插入两条经闭孔带，用于治疗SUI合并AVWP。采用盆腔脏器脱垂定量分期系统（POP-Q）对脱垂进行解剖学评估。通过咳嗽压力试验和国际尿失禁咨询委员会尿失禁问卷简表（ICIQ-SF）评估SUI。如果视觉模拟量表评分≥80分，我们认为患者满意。根据ICIQ-SF对尿失禁的严重程度进行分类。在术后3个月、12个月及每年对患者进行评估。
共有74名女性符合纳入标准且有足够记录用于分析。平均随访期为35.4个月（范围12 - 60个月）。手术时间为33.2±6.2分钟。SUI的客观治愈率和主观成功率分别为87.8%和93.2%。手术满意度也很高，为86.5%。我们系列研究中的解剖学成功率相当高，为96%。我们的总体并发症发生率为12.2%。网片外露率为0%。
双吊带手术可行、有效且安全。减小网片尺寸对SUI治疗及同时进行的AVWP修复结果没有不利影响。
