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初次剖宫产时膀胱瓣成形术后的泌尿系统症状:一项随机对照试验(RTC)

Urinary symptoms after bladder flap at the time of primary cesarean delivery: a randomized controlled trial (RTC).

作者信息

O'Boyle Amy L, Mulla Bethany M, Lamb Shannon V, Greer Joy A, Shippey Stuart H, Rollene Nanette L

机构信息

Walter Reed National Military Medical Center, Bethesda, MD, 20889-5600, USA.

Beth Israel Deaconess Medical Center, Boston, MA, USA.

出版信息

Int Urogynecol J. 2018 Feb;29(2):223-228. doi: 10.1007/s00192-017-3369-5. Epub 2017 Jun 2.

Abstract

INTRODUCTION AND HYPOTHESIS

The aim of this study was to evaluate urinary symptoms in the postpartum period after omission of the bladder flap at the time of primary cesarean delivery.

METHODS

This was a single-blind parallel-group randomized comparison (bladder flap, no bladder flap) in women scheduled for a primary cesarean delivery at 37 weeks gestation or later. The primary outcome was urinary symptom scores at 6-8 weeks postpartum. Secondary outcomes included comparisons of preoperative and postoperative pelvic floor symptom scores and the proportions of symptom bother responses between the study groups.

RESULTS

A total 43 women were available for analysis. Randomization was as follows: omission of the bladder flap (n = 22) and bladder flap (n = 21). Demographic characteristics and baseline pelvic floor symptom scores were similar between the groups. The primary outcome, urinary symptom scores at 6-8 weeks postpartum, did not differ significantly between the groups, but urinary symptom bother was significantly higher in women who received a bladder flap. Pelvic floor symptom scores improved significantly following delivery.

CONCLUSIONS

Urinary symptom scores as measured by the UDI-6 did not differ between women randomized to bladder flap or omission of the bladder flap, but the proportion of women with urinary symptom bother was significantly higher among those who received a bladder flap.

摘要

引言与假设

本研究旨在评估初次剖宫产时未行膀胱腹膜反折缝合术的产妇产后的泌尿系统症状。

方法

这是一项针对孕周37周及以上计划行初次剖宫产的女性的单盲平行组随机对照研究(膀胱腹膜反折缝合组、未行膀胱腹膜反折缝合组)。主要结局指标为产后6至8周时的泌尿系统症状评分。次要结局指标包括术前与术后盆底症状评分的比较以及研究组间症状困扰反应的比例。

结果

共有43名女性可供分析。随机分组情况如下:未行膀胱腹膜反折缝合术(n = 22)和膀胱腹膜反折缝合术(n = 21)。两组的人口统计学特征和基线盆底症状评分相似。主要结局指标,即产后6至8周时的泌尿系统症状评分,两组间无显著差异,但接受膀胱腹膜反折缝合术的女性泌尿系统症状困扰明显更高。产后盆底症状评分显著改善。

结论

采用UDI - 6量表测量的泌尿系统症状评分在随机分配至膀胱腹膜反折缝合组或未行膀胱腹膜反折缝合组的女性之间无差异,但接受膀胱腹膜反折缝合术的女性中出现泌尿系统症状困扰的比例明显更高。

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