Dessie Sybil G, Hacker Michele R, Apostolis Costas, Boundy Ellen O, Modest Anna M, Jones Stephanie-Marie L, Rosenblatt Peter L
From the *Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center; †Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston; and ‡Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, MA.
Female Pelvic Med Reconstr Surg. 2016 May-Jun;22(3):136-9. doi: 10.1097/SPV.0000000000000235.
The aim of this study was to determine whether the use of a preoperative transdermal scopolamine (TDS) patch for postoperative nausea and vomiting prophylaxis affects the success of a voiding trial after a transobturator tape sling procedure.
This study is a retrospective cohort study of adult women who underwent a transobturator tape sling procedure without concomitant procedures from February 1, 2009 through August 1, 2010. The exposed group included all eligible women who received a preoperative TDS patch. For each exposed woman, we selected the next 2 consecutive eligible women who did not receive a TDS patch to be included in the unexposed group. The primary outcome was postoperative voiding trial failure.
We identified 35 women who met eligibility criteria and used a preoperative TDS patch, and included 70 women who did not use a preoperative TDS. A significantly higher proportion of women in the TDS patch group (54.3%) failed their voiding trial than in the group that did not receive TDS (7.1%, P ≤ 0.001). A history of an incontinence procedure, older age, and higher body mass index strengthened the association between TDS patch and voiding trial failure. The adjusted model yielded a risk ratio for voiding trial failure of 13.8 (95% confidence interval, 5.2-36.5) for women who received TDS patch compared with those who did not.
The results of this study demonstrate that use of TDS patches for postoperative nausea and vomiting prophylaxis may negatively affect the success of voiding trials after transobturator tape sling procedures.
本研究旨在确定术前使用透皮东莨菪碱（TDS）贴剂预防术后恶心和呕吐是否会影响经闭孔带吊带手术后排尿试验的成功率。
本研究是一项回顾性队列研究，研究对象为2009年2月1日至2010年8月1日期间接受经闭孔带吊带手术且未同时进行其他手术的成年女性。暴露组包括所有接受术前TDS贴剂的符合条件的女性。对于每一位暴露组女性，我们选择接下来连续2位未接受TDS贴剂的符合条件的女性纳入非暴露组。主要结局是术后排尿试验失败。
我们确定了35名符合入选标准并使用术前TDS贴剂的女性，纳入了70名未使用术前TDS贴剂的女性。TDS贴剂组排尿试验失败的女性比例（54.3%）显著高于未接受TDS贴剂的组（7.1%，P≤0.001）。尿失禁手术史、年龄较大和体重指数较高加强了TDS贴剂与排尿试验失败之间的关联。与未接受TDS贴剂的女性相比，接受TDS贴剂的女性排尿试验失败的调整后风险比为13.8（95%置信区间，5.2 - 36.5）。
本研究结果表明，使用TDS贴剂预防术后恶心和呕吐可能会对经闭孔带吊带手术后排尿试验的成功率产生负面影响。
