Bayrak Omer, Seckiner Ilker, Urgun Gokhan, Sen Haluk, Ozcan Caglayan, Erturhan Sakip
Department of Urology , University of Gaziantep, Gaziantep, Turkey.
Department of Obstetrics and Gynecology, University of Gaziantep, Gaziantep, Turkey.
Int Braz J Urol. 2015 Jul-Aug;41(4):714-21. doi: 10.1590/S1677-5538.IBJU.2014.0209.
To compare transobturator midurethral sling (TOS) and single-incision sling procedures in terms of their effects on urinary incontinence and the quality of life in overweight (BMI ≥ 25-29.9 kg/m2) female patients using the International Consultation on Incontinence Questionnaire scoring form (ICIQ-SF) and Quality of Life of Persons with Urinary Incontinence scoring form (I-QOL).
In this prospective trial, the patients were divided into two groups consecutively; first 20 overweight female patients underwent the TOS (Unitape T®, Promedon, Cordoba, Argentina) procedure and the subsequent 20 consecutive overweight female patients underwent the single-incision sling [TVT-secur (Ethicon Inc., Sommerville, USA)] procedure. Age, urinary incontinence period, parity and daily pads usage were recorded. No usage of pads was defined as subjective cure rate postoperatively. Before the operation and 6. month after the surgery, the patients completed the ICIQ-SF and I-QOL.
There was no significant difference between the two groups in terms of mean age, duration of incontinence, parity, and BMI (p>0.05). ICIQ-SF and I-QOL revealed that the patients in the TOS group showed significantly better improvement (76.20% versus 64.10%, p=0.001, 81.31% versus 69.28%, p=0.001, respectively). In addition, subjective cure rates were found higher in TOS group (75% versus 55%, p=0.190).
The existing data is showed that incontinence symptoms and the quality of life have higher improvement in overweight female patients who underwent the TOS procedure. It is likely that the TOS procedure may provide stronger urethral support and better contributes to continence in this group of patients.
使用国际尿失禁咨询问卷评分表（ICIQ-SF）和尿失禁患者生活质量评分表（I-QOL），比较经闭孔中段尿道吊带术（TOS）和单切口吊带术对超重（体重指数[BMI]≥25 - 29.9kg/m²）女性患者尿失禁及生活质量的影响。
在这项前瞻性试验中，患者被连续分为两组；前20例超重女性患者接受TOS（Unitape T®，Promedon，科尔多瓦，阿根廷）手术，随后连续20例超重女性患者接受单切口吊带术[TVT-secur（美国强生公司，索默维尔）]手术。记录患者的年龄、尿失禁病程、产次和每日使用卫生巾情况。术后无卫生巾使用被定义为主观治愈率。手术前及术后6个月，患者完成ICIQ-SF和I-QOL。
两组在平均年龄、尿失禁持续时间、产次和BMI方面无显著差异（p>0.05）。ICIQ-SF和I-QOL显示，TOS组患者的改善明显更好（分别为76.20%对64.10%，p = 0.001；81.31%对69.28%，p = 0.001）。此外，TOS组的主观治愈率更高（75%对55%，p = 0.190）。
现有数据表明，接受TOS手术的超重女性患者尿失禁症状和生活质量改善更大。TOS手术可能为该组患者提供更强的尿道支撑，更好地促进控尿。
