Kluz Tomasz, Wlaźlak Edyta, Wróbel Andrzej, Wlaźlak Wiktor, Pazdrak Michał, Surkont Grzegorz
Ginekol Pol. 2017;88(8):407-413. doi: 10.5603/GP.a2017.0076.
The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling - Ajust™.
One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location. PFS-TV was performed under standardized conditions at rest and during maximum Valsalva maneuver.
This is a retrospective analysis of data from a total of 31 patients who attended a control visit between the 36th and the 50th month following the operation. Sixteen patients (51.6%) were cured. There were statistically significant differences in urethral mobility (p < 0.0007) and tape-urethra distance (p < 0.002) between cured and not-cured group. The difference in urethral length was not statistically significant. 77.8% of women with a hypermobile urethra was cured in contrast to 15.4% with a normobile urethra. Neither of the groups had a hypomobile urethra patient. There were no significant complications intra- or post-operatively. De novo urgency was observed in 1 patient only.
Implantation of Ajust tape seems to be a safe mode of operative treatment for SUI in women. Our mid-term results suggest that long term effects might be worse compared to retropubic or transobturator tapes, especially at first operative experience with Ajust. Urethral mobility seems to be an important risk factor for treatment failure after Ajust implantation. It seems that patients that may benefit from Ajust most are women with urethral hypomobility but this needs to be verified with a prospective study.
本研究旨在使用耻骨后尿道吊带电视检查法（PFS-TV）评估我们首次植入单切口吊带Ajust™的手术中期结果。
同一位外科医生为所有有压力性尿失禁症状的患者进行手术。仅实施了Ajust手术。术后评估包括：标准化访谈与检查、咳嗽试验以及用于评估尿失禁和吊带位置的PFS-TV。PFS-TV在静息状态和最大瓦尔萨尔瓦动作期间的标准化条件下进行。
这是一项对31例患者数据的回顾性分析，这些患者在术后第36至50个月进行了对照访视。16例患者（51.6%）治愈。治愈组与未治愈组在尿道活动度（p < 0.0007）和吊带 -尿道距离（p < 0.002）方面存在统计学显著差异。尿道长度差异无统计学意义。尿道活动度过高的女性中有77.8%治愈，而尿道活动度正常的女性中这一比例为15.4%。两组均无尿道活动度过低的患者。术中及术后均无显著并发症。仅1例患者出现新发尿急。
植入Ajust吊带似乎是女性压力性尿失禁手术治疗的一种安全方式。我们的中期结果表明，与耻骨后或经闭孔吊带相比，长期效果可能更差，尤其是在首次使用Ajust手术时。尿道活动度似乎是Ajust植入后治疗失败的一个重要风险因素。似乎最可能从Ajust中获益的患者是尿道活动度过低的女性，但这需要前瞻性研究来验证。
