Abraham Nitya, Makovey Iryna, King Ashley, Goldman Howard B, Vasavada Sandip
Department of Urology, Montefiore Medical Center, Bronx, New York.
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
Neurourol Urodyn. 2017 Feb;36(2):349-353. doi: 10.1002/nau.22927. Epub 2015 Nov 20.
The primary objectives were to describe the rate of repeat surgery for stress urinary incontinence (SUI) after release of an obstructing synthetic mid-urethral sling (MUS) and to evaluate the effect of time from sling placement to sling release on repeat surgery rates. The secondary objective was to assess rates of recurrent and persistent SUI.
This is a retrospective review of women who underwent synthetic MUS release (incision or excision of segment of sling) from 2005-2013. SUI rates and repeat surgery were ascertained by patient report and urinary distress inventory (UDI-6) questionnaire responses. Data analysis included descriptive statistics and multivariable logistic regression analysis.
107 patients were included. Median time to sling release was 22 months (IQR 5-49 months). 43.2% were transobturator slings. 15/107 patients (14%) underwent repeat surgery for SUI. On multivariable analysis, women were significantly less likely to undergo repeat surgery for SUI when sling release was performed >24 months after initial sling surgery (OR 0.12, 95% CI 0.02-0.85, P = 0.03) compared to release within 3 months. 49% and 77% reported recurrent and persistent SUI after sling release, of which 83% were significantly bothered.
The repeat surgery rate for SUI was 14%. The rate of recurrent SUI was 49%. Most of these women were significantly bothered. On multivariate analysis, longer interval to sling release was associated with decreased likelihood of repeat surgery for SUI. The reason for a low repeat surgery rate for SUI despite a high rate of bothersome SUI should be explored in future studies. Neurourol. Urodynam. 36:349-353, 2017. © 2015 Wiley Periodicals, Inc.
主要目标是描述在取出阻塞性合成尿道中段吊带（MUS）后压力性尿失禁（SUI）的再次手术率，并评估从吊带置入到取出的时间对再次手术率的影响。次要目标是评估复发性和持续性SUI的发生率。
这是一项对2005年至2013年期间接受合成MUS取出术（吊带部分的切开或切除）的女性进行的回顾性研究。SUI发生率和再次手术情况通过患者报告和尿失禁困扰量表（UDI-6）问卷回答来确定。数据分析包括描述性统计和多变量逻辑回归分析。
纳入107例患者。吊带取出的中位时间为22个月（四分位间距5 - 49个月）。43.2%为经闭孔吊带。107例患者中有15例（14%）因SUI接受了再次手术。在多变量分析中，与在初次吊带手术后3个月内取出相比，在初次吊带手术后>24个月进行吊带取出的女性因SUI接受再次手术的可能性显著降低（比值比0.12，95%置信区间0.02 - 0.85，P = 0.03）。49%和77%的患者报告在吊带取出后出现复发性和持续性SUI，其中83%的患者受到严重困扰。
SUI的再次手术率为14%。复发性SUI的发生率为49%。这些女性中的大多数受到严重困扰。在多变量分析中，吊带取出间隔时间较长与SUI再次手术可能性降低相关。尽管令人困扰的SUI发生率较高，但SUI再次手术率较低的原因应在未来研究中进行探索。《神经泌尿学与尿动力学》36:349 - 353，2017。©2015威利期刊公司
