Kitagawa Yasuhide, Narimoto Kazutaka, Urata Satoko, Kawaguchi Shohei, Kuribayashi Masato, Namiki Mikio
Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8640, Japan.
Int Urogynecol J. 2016 Jul;27(7):1075-80. doi: 10.1007/s00192-016-2943-6. Epub 2016 Jan 25.
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.
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.
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.
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.
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。
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。
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。
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。