Schachar Jeffrey S, Williams Kathryn S, Winkler Harvey A
Division of Obstetrics and Gynecology, North Shore University Hospital, Northwell Health System, Great Neck, New York, USA.
Division of Urogynecology, Female Pelvic Medicine and Reconstructive Surgery, North Shore University Hospital, Northwell Health System, Great Neck, New York, USA.
J Midlife Health. 2018 Jan-Mar;9(1):26-31. doi: 10.4103/jmh.JMH_64_17.
The objective of this study was to assess long-term postoperative urinary incontinence (UI) symptoms and quality of life (QOL) in patients after robotic-assisted sacrocolpopexy (RASC) with or without concomitant midurethral sling (MUS).
This is a cross-sectional survey of patients comparing long-term postoperative urinary symptoms and QOL measurements in women who underwent RASC with or without MUS. We included all patients from 2011 to 2014 who had RASC with or without MUS. All patients had preoperative urodynamic testing (UDS). Patients who demonstrated stress UI on UDS underwent MUS at the time of RASC. Urinary symptoms and QOL were assessed through the validated Urinary Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) patient questionnaires.
Sixty-eight patients met inclusion criteria, 46 patients completed follow-up questionnaires, and were included in the final analysis. Average length of time to follow-up from surgery was 24 months (range: 6-36 months). A statistically significant difference in UDI-6 scores between the two groups (RASC vs. RASC + MUS) was observed. Median (25 and 75 percentiles) scores for UDI-6 were 22.92 (8.33 and 32.29, respectively) for the RASC group and 4.17 (0 and 13.54, respectively) for the RASC + MUS group ( = 0.0017). Median scores for IIQ-7 were 0 (0 and 29.73 for the 25 and 75 percentiles, respectively) for the RASC group and 0 (0 and 0, respectively) for the RASC + MUS group ( = 0.1691).
Patients who underwent RASC + MUS scored significantly lower on the UDI-6, indicating fewer urinary distress symptoms. Although not statistically significant, patients in the RASC + MUS group had lower IIQ-7 scores, indicating less negative impact on QOL, compared to the RASC-only group.
本研究的目的是评估接受机器人辅助骶骨阴道固定术（RASC）加或不加伴发尿道中段吊带术（MUS）的患者术后长期尿失禁（UI）症状及生活质量（QOL）。
这是一项对患者的横断面调查，比较接受RASC加或不加MUS的女性术后长期泌尿系统症状及生活质量测量结果。我们纳入了2011年至2014年所有接受RASC加或不加MUS的患者。所有患者术前均进行了尿动力学检查（UDS）。在UDS中表现为压力性尿失禁的患者在RASC时接受了MUS。通过经过验证的尿失禁困扰量表-6（UDI-6）和尿失禁影响问卷-7（IIQ-7）患者问卷对泌尿系统症状和生活质量进行评估。
68例患者符合纳入标准，46例患者完成随访问卷并纳入最终分析。手术至随访的平均时间为24个月（范围：6 - 36个月）。观察到两组（RASC组与RASC + MUS组）UDI-6评分存在统计学显著差异。RASC组UDI-6的中位数（第25和第75百分位数）评分分别为22.92（8.33和32.29），RASC + MUS组为4.17（0和13.54）（P = 0.0017）。RASC组IIQ-7的中位数评分为0（第25和第75百分位数分别为0和29.73），RASC + MUS组为0（分别为0和0）（P = 0.1691）。
接受RASC + MUS的患者在UDI-6上得分显著更低，表明泌尿系统困扰症状更少。虽然无统计学显著差异，但与仅接受RASC组相比，RASC + MUS组患者的IIQ-7评分更低，表明对生活质量的负面影响更小。
