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采用尿动力学和问卷调查评估经闭孔尿道中段吊带术治疗压力性尿失禁的疗效。

Evaluation of the efficacy of transobturator tape surgery in the treatment of stress urinary incontinence using urodynamics and questionnaires.

作者信息

Aygül Cihan, Özyurt Ramazan, Şık Bulat Aytek, Kumbasar Serkan

机构信息

İstanbul Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.

İstanbul Aydın University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey.

出版信息

Turk J Obstet Gynecol. 2016 Dec;13(4):172-177. doi: 10.4274/tjod.46034. Epub 2016 Dec 15.

Abstract

OBJECTIVE

To measure the efficiency of transobturator tape (TOT) surgery using urodynamics and questionnaires in stress urinary incontinence.

MATERIALS AND METHODS

Ninety-two patients with stress and mixed urinary incontinency who underwent TOT surgery were selected for the study. We retrospectively examined the patients' urodynamics, ultrasonography, demographic characteristics, incontinency surveys, life quality scores [incontinence impact questionnaire, (IQ-7) and urinary distress inventory (UDI-6)], diagnostic findings, Q-type test, surgical records, and complications. Patients treatment adherence, life quality scores, and urodynamics were evaluated as per the findings and complications following discharge of the patients between 12 and 36 months. Patients with a surgical history as the result of incontinence were excluded from the study.

RESULTS

Prior to surgery, 57 (61%, 95) patients had stress urinary incontinence (SUI), and 35 (38%, 05) patients had mixed urinary incontinence (MUI). During surgery, 45 (48%, 91) patients underwent extra pelvic surgical intervention. The mean follow-up time was 22.17±7.55 months. Our subjective success rate was 91%, 3 and the objective success rate was 78%, 3. In the life quality evaluation, a statistically significant improvement was found between IIQ-7 and UDI-6 scores. Parity over 4 was an important failure reason. Two (2%, 17) patients developed vaginal erosion, 2 (2%, 17) of the patients developed temporary urine retention, and 1 (1%, 08) patient developed nova urge incontinence.

CONCLUSION

Our study demonstrates that TOT surgery provides high objective and subjective success and has a positive impact on life quality. The ease of application and lower complication rate makes TOT a valuable alternative for other treatment approaches in the surgical treatment of SUI.

摘要

目的

采用尿动力学检查和问卷调查评估经闭孔尿道中段悬吊带术(TOT)治疗压力性尿失禁的疗效。

材料与方法

选取92例接受TOT手术治疗的压力性和混合性尿失禁患者进行研究。我们回顾性分析了患者的尿动力学检查、超声检查、人口统计学特征、失禁调查、生活质量评分[失禁影响问卷(IQ-7)和尿路困扰量表(UDI-6)]、诊断结果、Q型试验、手术记录及并发症。根据患者出院后12至36个月的检查结果和并发症情况,评估患者的治疗依从性、生活质量评分及尿动力学情况。有因失禁而进行手术史的患者被排除在研究之外。

结果

手术前,57例(61%,95)患者为压力性尿失禁(SUI),35例(38%,05)患者为混合性尿失禁(MUI)。手术过程中,45例(48%,91)患者接受了盆腔外手术干预。平均随访时间为22.17±7.55个月。主观成功率为91%,3;客观成功率为78%,3。在生活质量评估中,IIQ-7和UDI-6评分之间存在统计学上的显著改善。分娩次数超过4次是一个重要的失败原因。2例(2%,17)患者出现阴道糜烂,2例(2%,17)患者出现暂时性尿潴留,1例(1%,08)患者出现新发急迫性尿失禁。

结论

我们的研究表明,TOT手术具有较高的客观和主观成功率,并对生活质量有积极影响。其操作简便且并发症发生率较低,使TOT成为SUI手术治疗中其他治疗方法的一个有价值的替代方案。

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