Anding Ralf, Schoen Manuel, Kirschner-Hermanns Ruth, Fisang Christian, Müller Stefan C, Latz Stefan
Department of Urology and Neuro-Urology, University Hospital Bonn, Germany.
Department of Urology, Klinikum Ibbenbueren GmbH, Germany.
Int Braz J Urol. 2017 Mar-Apr;43(2):280-288. doi: 10.1590/S1677-5538.IBJU.2015.0751. Epub 2017 Jan 27.
The prevalence of urinary incontinence is increasing. Two major risk factors are overweight and age. We present objective and subjective cure rates of elderly and overweight patients treated with an adjustable single-incision sling system (AJUST™, C.R. BARD, Inc.).
Between 04/2009 and 02/2012 we treated 100 female patients with the single incision sling. Patients were retrospectively evaluated by Stamey degree of incontinence, cough test, pad use, and overall satisfaction. The primary outcomes of the study were objective and subjective cure rates, secondary outcomes were the safety profile of the sling and complications.
The overall success rate in this population was 84.6% with a mean follow-up of 9.3 months. The average usage of pads per day decreased from 4.9 to 1.6 and was significantly lower in patients with a BMI <30 (p=0.004). Postoperative residual SUI was also lower in patients with a BMI <30 (p=0.006). Postoperative satisfaction was better in patients with a lower BMI, but this difference did not reach a level of significance (p=0.055). There were no complications such as bleeding, bladder injury, or tape infection.
In elderly and obese patients a considerable success rate is achievable with this quick and minimal invasive procedure. However, the success rate shows a clear trend in favor of a lower body-mass-index. The cut-off point has been identified at a BMI of 30. The AJUST™ system can be regarded as safe and beneficial for elderly and obese patients.
尿失禁的患病率正在上升。两个主要风险因素是超重和年龄。我们展示了使用可调节单切口吊带系统（AJUST™，C.R.巴德公司）治疗的老年和超重患者的客观和主观治愈率。
在2009年4月至2012年2月期间，我们用单切口吊带治疗了100名女性患者。通过斯坦梅伊尿失禁程度、咳嗽试验、护垫使用情况和总体满意度对患者进行回顾性评估。该研究的主要结果是客观和主观治愈率，次要结果是吊带的安全性和并发症。
该人群的总体成功率为84.6%，平均随访9.3个月。每天护垫的平均使用量从4.9片降至1.6片，在体重指数（BMI）<30的患者中显著更低（p = 0.004）。BMI<30的患者术后残余压力性尿失禁也更低（p = 0.006）。BMI较低的患者术后满意度更高，但这种差异未达到显著水平（p = 0.055）。没有出现出血、膀胱损伤或吊带感染等并发症。
对于老年和肥胖患者，通过这种快速且微创的手术可取得相当高的成功率。然而，成功率呈现出明显有利于较低体重指数的趋势。已确定BMI为30时为临界点。AJUST™系统可被视为对老年和肥胖患者安全且有益。
