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用于治疗压力性尿失禁的迷你吊带(奥菲拉)与耻骨后阴道吊带:中期随访

Mini Sling (Ophira) versus Pubovaginal Sling for Treatment of Stress Urinary Incontinence: A Medium-term Follow-up.

作者信息

Sharifiaghdas Farzaneh, Nasiri Mahmoodreza, Mirzaei Mahboubeh, Narouie Behzad

机构信息

Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Urology, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Prague Med Rep. 2015;116(3):210-8. doi: 10.14712/23362936.2015.60.

Abstract

To compare two different procedures, mid-urethral mini sling (Ophira) and autologous rectus fascia sling, according to their medium-term subjective and objective outcome and satisfaction rates in the treatment of stress urinary incontinence in women. One hundred women with the main complaint of stress urinary incontinence were randomized to be treated with either mini sling (Ophira) or autologous rectus facia pubovaginal sling. Preoperative evaluation consisted of: physical examination, blood biochemistry urine analysis and culture, urinary tract ultrasound scan, conventional multi-channel urodynamic study, cystourethroscopy, cough induced stress test and Incontinence Impact Questionnaire (IIQ). The patients were objectively and subjectively re-evaluated at 1, 3, 6 and 12 postoperative months and the last visit and the collected data of more than one year follow-up were compared with preoperative assessments. Seventy two out of one hundred patients were followed for a mean time of 13.8±4.4 months (12-20 months range). Objective cure rate, according to cough-induced stress test was recorded in 88.6% and 89.2% of the mini sling (Ophira) and the rectus facia sling group respectively (P=1.0). Postoperative mean IIQ score decreased to 42.7±11.4 and 50.2±11.1 in the mini sling (Ophira) group versus rectus facia pubovaginal sling (P=0.007). Twenty eight (80%) and 23 (67%) patients in the mini sling (Ophira) and rectus facia pubovaginal sling were satisfied with the operation (P=0.23). There is no significant difference between the mini sling (Ophira) and autologous rectus fascia sling procedure in the treatment of stress urinary incontinence at medium-term follow-up.

摘要

为比较两种不同的手术方法,即尿道中段迷你吊带术(Ophira)和自体腹直肌筋膜吊带术,观察其治疗女性压力性尿失禁的中期主观和客观疗效及满意度。将100例以压力性尿失禁为主诉的女性随机分为两组,分别接受迷你吊带术(Ophira)或自体腹直肌耻骨阴道吊带术治疗。术前评估包括:体格检查、血液生化、尿液分析及培养、泌尿系统超声扫描、常规多通道尿动力学检查、膀胱尿道镜检查、咳嗽诱发压力试验及尿失禁影响问卷(IIQ)。术后1、3、6和12个月以及最后一次随访时对患者进行客观和主观再评估,并将收集到的一年以上随访数据与术前评估进行比较。100例患者中有72例得到随访,平均随访时间为13.8±4.4个月(范围12 - 20个月)。根据咳嗽诱发压力试验,迷你吊带术(Ophira)组和腹直肌筋膜吊带术组的客观治愈率分别为88.6%和89.2%(P = 1.0)。迷你吊带术(Ophira)组术后平均IIQ评分降至42.7±11.4,而耻骨阴道腹直肌筋膜吊带术组为50.2±11.1(P = 0.007)。迷你吊带术(Ophira)组和耻骨阴道腹直肌筋膜吊带术组分别有28例(80%)和23例(67%)患者对手术满意(P = 0.23)。在中期随访中,迷你吊带术(Ophira)和自体腹直肌筋膜吊带术治疗压力性尿失禁的效果无显著差异。

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