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压力性尿失禁女性的高尿流率:经闭孔尿道中段悬吊带术后校正的尿流率-年龄列线图评估

High urinary flow in women with stress incontinence: corrected flow-age nomogram evaluation after a transobturator tape procedure.

作者信息

Kitagawa Yasuhide, Narimoto Kazutaka, Urata Satoko, Kawaguchi Shohei, Kuribayashi Masato, Namiki Mikio

机构信息

Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8640, Japan.

出版信息

Int Urogynecol J. 2016 Jul;27(7):1075-80. doi: 10.1007/s00192-016-2943-6. Epub 2016 Jan 25.

Abstract

INTRODUCTION AND HYPOTHESIS

We noninvasively compared urinary flow in both pre- and post-transobturator tape (TOT) procedures in stress urinary incontinence (SUI) patients using previously reported corrected flow-age nomograms in healthy women.

METHODS

This retrospective cohort study included patients who underwent a successful TOT procedure to treat SUI. Non-instrumented uroflowmetry was performed before and 3 months after surgery. Corrected maximum flow rate (cQmax) and average flow rate (cQave) were calculated using Qmax/√voided volume (VV) and Qave/√VV respectively. The ratio of corrected flow to age-adjusted corrected flow in healthy women was calculated in each patient. Each parameter was compared against pre-TOT and 3-months post-TOT values.

RESULTS

Sixty-two patients were eligible for study inclusion. All urinary flow parameters were significantly higher pre-TOT than at 3 months post-TOT. The number of patients with cQmax and cQave over mean flow-age nomogram, compared with healthy women, before the TOT procedure decreased 3 months post-TOT; however, in many patients, cQmax and cQave were higher than in the corrected flow-age nomogram post-TOT. No significant difference in the ratio of cQmax to age-adjusted cQmax between pre- and post-TOT in the normal urinary flow group was observed, but significantly decreased in the high urinary flow group 3 months after TOT.

CONCLUSIONS

Urinary flow rates were higher in SUI patients compared with age-matched controls and successful TOT procedures normalized urinary flows in patients with high urinary flow. A simple evaluation of urinary flow using a corrected flow-age nomogram may be clinically useful in SUI patients.

摘要

引言与假设

我们使用先前报道的健康女性校正流量-年龄列线图,对压力性尿失禁(SUI)患者经闭孔尿道中段吊带术(TOT)前后的尿流进行了无创比较。

方法

这项回顾性队列研究纳入了接受成功TOT手术治疗SUI的患者。在手术前和术后3个月进行了非仪器化尿流率测定。分别使用Qmax/√排尿量(VV)和Qave/√VV计算校正最大尿流率(cQmax)和平均尿流率(cQave)。计算每位患者校正尿流与健康女性年龄校正后校正尿流的比值。将每个参数与TOT术前和术后3个月的值进行比较。

结果

62例患者符合研究纳入标准。所有尿流参数在TOT术前均显著高于术后3个月。与健康女性相比,TOT术前cQmax和cQave超过平均流量-年龄列线图的患者数量在TOT术后3个月减少;然而,在许多患者中,cQmax和cQave高于TOT术后校正流量-年龄列线图中的值。正常尿流组TOT术前和术后cQmax与年龄校正后cQmax的比值无显著差异,但高尿流组在TOT术后3个月显著降低。

结论

与年龄匹配的对照组相比,SUI患者的尿流率更高,成功的TOT手术使高尿流患者的尿流正常化。使用校正流量-年龄列线图对尿流进行简单评估可能对SUI患者具有临床实用性。

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