Sherif Hammouda, Othman Tarek Soliman, Eldkhakhany Amr, Elkady Hussein, Elfallah Adel
Department of Urology, Benha University School of Medicine, Benha, Egypt.
Turk J Urol. 2017 Dec;43(4):517-524. doi: 10.5152/tud.2017.29000. Epub 2017 Dec 1.
This study aims to evaluate safety and efficacy of four arms polypropylene mesh in the long- term follow-up in the management of stress urinary incontinence (SUI) associated with cystocele.
This prospective study was conducted on 50 female patients with SUI associated with cystocele. Patients underwent placement of transobturator four-arms mesh implants. Stress incontinence was evaluated using cough stress test with and without prolapse reduction, Stamey's grading of SUI, the validated Arabic version of the International Consultation on Incontinence Questionnaire-Short Form and King Health Questionnaire forms. Perioperative parameters evaluated included age, body mass index, grade of SUI, time of procedure, hospital stay after surgery, difference between pre-, and postoperative serum hemoglobin values, and need for blood transfusion. Follow- up visits were planned at 3, 9 and 18 months after surgery.
The mean operative time was 37.4±10.2 (25-60) minutes. Blood transfusion was not required. The mean hospital stay was 30.5±10 (24-48) hrs. Five (10%) patients had fever and urinary tract infections were noticed in five (10%) patients. Two (4%) women had urine retention after catheter removal and vaginal mesh erosion was present in one (2%) patient. Forty (80%) patients were cured from SUI, 8 (16%) patients were improved and 2 (4%) patients failed to respond.
Cystocele associated with SUI can be repaired with transobturator four-arms mesh with promising results, improved quality of life, and tolerable side effects.
本研究旨在评估四臂聚丙烯网片在长期随访中治疗膀胱膨出相关压力性尿失禁（SUI）的安全性和有效性。
本前瞻性研究对50例膀胱膨出相关SUI的女性患者进行。患者接受经闭孔四臂网片植入。使用咳嗽压力试验（有无脱垂复位）、SUI的Stamey分级、经验证的阿拉伯语版国际尿失禁咨询问卷简表和King健康问卷表格评估压力性尿失禁。评估的围手术期参数包括年龄、体重指数、SUI分级、手术时间、术后住院时间、术前和术后血清血红蛋白值的差异以及输血需求。计划在术后3、9和18个月进行随访。
平均手术时间为37.4±10.2（25 - 60）分钟。无需输血。平均住院时间为30.5±10（24 - 48）小时。5例（10%）患者发热，5例（10%）患者出现尿路感染。2例（4%）女性在拔除导尿管后出现尿潴留，1例（2%）患者出现阴道网片侵蚀。40例（80%）患者的SUI得到治愈，8例（16%）患者有所改善，2例（4%）患者无反应。
膀胱膨出相关SUI可用经闭孔四臂网片修复，效果良好，生活质量提高，副作用可耐受。
