Gynecologic and Obstetric Clinic, Dep. of Clinical and Experimental Medicine, University of Sassari.
Urologic Clinic, Dep. of Clinical and Experimental Medicine, University of Sassari.
Maturitas. 2018 Mar;109:32-38. doi: 10.1016/j.maturitas.2017.12.008. Epub 2017 Dec 9.
Stress urinary incontinence (SUI) is a condition characterized by an involuntary loss of urine occurring as result of an increase in intra-abdominal pressure due to effort or exertion or on sneezing or coughing. Estimates of its prevalence in the female population range from 10% to 40%. A literature search of the Medline, Cochrane library, EMBASE, NLH, ClinicalTrials.gov and Google Scholar databases was done up to July 2017, restricted to English-language articles, using terms related to SUI, medical therapy, surgical therapy and treatment options. The search terms included female stress urinary incontinence, mid-urethral sling, tension-free vaginal tape (TVT) and transobturator tape (TOT, TVT-O). Original articles, reviews and meta-analyses were included. Surgical therapy should be considered only after conservative therapies (e.g. an exercise programme or topical estrogens) have failed. Synthetic mid-urethral slings are the gold standard for the surgical treatment of SUI according to the 2016 guidelines of the European Society of Urology (ESU) and the 2017 position statement of the European Urogynaecological Association (EUA). The therapeutic options are numerous but further research into new therapeutic strategies is needed to achieve a better balance between efficacy and adverse events.
压力性尿失禁（SUI）是一种病症，其特征为由于腹部用力或活动、打喷嚏或咳嗽导致腹内压增加而出现不自主的尿液漏出。女性人群中该病的患病率估计为 10%至 40%。对截至 2017 年 7 月的 Medline、Cochrane 图书馆、EMBASE、NLH、ClinicalTrials.gov 和 Google Scholar 数据库进行了文献检索，检索时使用了与 SUI、药物治疗、手术治疗和治疗选择相关的术语，检索语言为英文。检索词包括女性压力性尿失禁、尿道中段吊带术、无张力阴道吊带术（TVT）和经闭孔吊带术（TOT、TVT-O）。纳入了原始文章、综述和荟萃分析。只有在保守治疗（如运动方案或局部雌激素治疗）失败后，才应考虑手术治疗。根据 2016 年欧洲泌尿外科学会（ESU）指南和 2017 年欧洲泌尿妇科协会（EUA）立场声明，合成尿道中段吊带术是治疗 SUI 的金标准。治疗选择多种多样，但需要进一步研究新的治疗策略，以在疗效和不良事件之间取得更好的平衡。
