Jun Taeyong, Yoon Hyun Sik, Kim Hyung Suk, Lee Jeong Woo, Bae Jungbum, Lee Hae Won
Department of Urology, Dongguk University Ilsan Hospital, Goyang, Korea.
Investig Clin Urol. 2017 Jan;58(1):54-60. doi: 10.4111/icu.2017.58.1.54. Epub 2017 Jan 9.
To assess recurrence rates of urinary incontinence in women with initial cure after transobturator tape (TOT) procedure at 3-year follow-up.
Between June 2006 and May 2013, a total of 402 consecutive patients underwent the TOT procedure for female stress urinary incontinence (SUI) at Dongguk University Ilsan Hospital. Of the 402 patients, 223 had sufficient medical records for analysis. Therefore, they were followed-up for 3 years postoperatively. Patient characteristics, urinary symptoms, physical examination, and urodynamic parameters were evaluated. The primary end point of "cure" was defined as the absence of any complaint of urinary leakage without needing pads for usual activities.
Of the 223 patients, 196 patients (87.9%) were initially cured within 6 months postoperatively. Of the 196 patients, 70 (35.7%) had recurrent urinary incontinence at 3 years postoperatively, 51 (26.0%) had SUI, 16 (8.2%) had urgency urinary incontinence, and 3 (1.5%) had mixed urinary incontinence. In univariate analysis, preoperative urinary obstructive symptom was found to significant contributor to the recurrence of urinary incontinence at 3-year postoperatively (p=0.004).
In our study, 35.7% of the women with initial cure after TOT experienced the recurrence of urinary leakage during the 3-year follow-up. The cure rate of TOT was decreased as time went by, although the initial cure rate was high.
评估经闭孔尿道中段悬吊带术(TOT)术后最初治愈的女性在3年随访期内尿失禁的复发率。
2006年6月至2013年5月期间,东国大学一山医院共有402例连续性患者因女性压力性尿失禁(SUI)接受了TOT手术。在这402例患者中,223例有足够的病历资料用于分析。因此,对他们进行了术后3年的随访。评估了患者的特征、泌尿系统症状、体格检查和尿动力学参数。“治愈”的主要终点定义为在日常活动中没有任何漏尿主诉且无需使用尿垫。
在223例患者中,196例(87.9%)在术后6个月内最初治愈。在这196例患者中,70例(35.7%)在术后3年出现复发性尿失禁,51例(26.0%)为压力性尿失禁,16例(8.2%)为急迫性尿失禁,3例(1.5%)为混合性尿失禁。在单因素分析中,术前尿路梗阻症状被发现是术后3年尿失禁复发的重要因素(p=0.004)。
在我们的研究中,TOT术后最初治愈的女性中有35.7%在3年随访期内出现漏尿复发。尽管最初治愈率较高,但TOT的治愈率随着时间的推移而降低。