Holdø Bjørn, Verelst Margareta, Svenningsen Rune, Milsom Ian, Skjeldestad Finn Egil
Department of Obstetrics and Gynecology, Nordland Hospital, Parkveien 95, 8005, Bodø, Norway.
Division of Surgery, Oncology and Women's Health, University Hospital of North Norway, Tromsø, Norway.
Int Urogynecol J. 2017 Nov;28(11):1739-1746. doi: 10.1007/s00192-017-3345-0. Epub 2017 Apr 24.
The retropubic tension-free vaginal tape (TVT) procedure replaced Burch colposuspension as the primary surgical method for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) in women in our department in 1998. In this study we compared the short-term and long-term clinical outcomes of these surgical procedures.
Using a case series design, we compared the last 5 years of the Burch procedure (n = 127, 1994-1999) with the first 5 years of the retropubic TVT procedure (n = 180, 1998-2002). Information from the medical records was transferred to a case report form comprising data on perioperative and long-term complications as well as recurrence of UI, defined as bothersome UI or UI in need of repeat surgery. Other endpoints were rates of perioperative and late complications and the rates of prolapse surgery after primary surgery. The data were analyzed with the chi-squared and t tests and survival analysis using SPSS.
The cumulative recurrence rate of SUI in women with preoperative SUI was significantly higher after the Burch procedure, but no difference was observed in women with MUI. There were no significant differences in rates of perioperative and late complications. At 12 years there was a significant increase in rates of repeat surgery for incontinence and prolapse in women after the Burch procedure.
The long-term efficacy of TVT surgery was superior to that of Burch colposuspension in women with SUI. In addition, the rate of late prolapse surgery was significantly higher after the Burch procedure.
耻骨后无张力阴道吊带术（TVT）于1998年在我院取代了Burch阴道悬吊术，成为女性压力性尿失禁（SUI）和混合性尿失禁（MUI）的主要手术方法。在本研究中，我们比较了这两种手术的短期和长期临床结果。
采用病例系列设计，我们将过去5年的Burch手术（n = 127，1994 - 1999年）与耻骨后TVT手术的前5年（n = 180，1998 - 2002年）进行了比较。病历信息被录入一份病例报告表，其中包括围手术期和长期并发症以及尿失禁复发的数据，尿失禁复发定义为令人困扰的尿失禁或需要再次手术的尿失禁。其他终点指标为围手术期和晚期并发症的发生率以及初次手术后脱垂手术的发生率。使用SPSS软件对数据进行卡方检验、t检验和生存分析。
术前患有SUI的女性在接受Burch手术后，SUI的累积复发率显著更高，但在患有MUI的女性中未观察到差异。围手术期和晚期并发症的发生率没有显著差异。在术后12年，接受Burch手术的女性因尿失禁和脱垂进行再次手术的发生率显著增加。
对于患有SUI的女性，TVT手术的长期疗效优于Burch阴道悬吊术。此外，Burch手术后晚期脱垂手术的发生率显著更高。
