Ugianskiene Aiste, Kjærgaard Niels, Larsen Thomas, Glavind Karin
Department of Obstetrics and Gynecology, Aalborg University Hospital (AAUH), Reberbansgade 15, 9000, Aalborg, Denmark.
Int Urogynecol J. 2019 Jul;30(7):1147-1152. doi: 10.1007/s00192-018-3677-4. Epub 2018 Jun 5.
The beneficial effect of pelvic organ prolapse (POP) surgery on urge urinary incontinence (UI) is well described in the literature, while effect on preoperative stress UI (SUI) is still unclear. The aim of this study was to investigate changes concerning UUI following POP surgery without concomitant anti-incontinence procedures and to identify possible factors influencing the changes.
We conducted a retrospective study of 678 women with prolapse surgery using native tissue repair during a 3-year period. Patients completed three prolapse questions from the International Consultation on Incontinence-Vaginal Symptoms (ICIQ-VS) questionnaire and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before undergoing surgery and 3 months postoperatively. Patients who scored >0 on the ICIQ-UI SF before surgery were included in the study.
A total of 379 patients (55.9%) with POP had concomitant UI. At 3 months' follow-up, 174 patients (46%) became continent compared with 205 patients (54%) with UI. Patients with remaining UI had statistically significant higher mean preoperative ICIQ-UI SF score than patients who became dry. The risk of remaining UI after POP surgery was greater in patients with previous anti-incontinence repair. UI type was not a risk factor for its persistance.
Almost half of the patients with UI before POP surgery became completely dry after prolapse surgery alone. Severity of incontinence and previous anti-incontinence surgery were identified as risk factors for persisting UI after POP surgery. We found a reduction of incontinence after an operation in any of the three compartments.
盆腔器官脱垂（POP）手术对急迫性尿失禁（UI）的有益效果在文献中已有充分描述，而其对术前压力性尿失禁（SUI）的影响仍不明确。本研究的目的是调查在未同时进行抗尿失禁手术的情况下，POP手术后急迫性尿失禁（UUI）的变化，并确定可能影响这些变化的因素。
我们对678例在3年期间接受自体组织修复脱垂手术的女性进行了一项回顾性研究。患者在手术前和术后3个月完成了国际尿失禁咨询委员会 - 阴道症状问卷（ICIQ - VS）中的三个脱垂问题以及国际尿失禁咨询委员会问卷 - 尿失禁简表（ICIQ - UI SF）。手术前ICIQ - UI SF评分>0的患者被纳入研究。
共有379例（55.9%）POP患者伴有UI。在3个月的随访中，174例患者（46%）尿失禁症状消失，而205例患者（54%）仍有UI。仍有UI的患者术前ICIQ - UI SF平均评分在统计学上显著高于尿失禁症状消失的患者。既往有抗尿失禁修复手术的患者在POP手术后仍有UI的风险更大。UI类型不是其持续存在的危险因素。
几乎一半的POP手术前有UI的患者仅通过脱垂手术就完全不再尿失禁。尿失禁的严重程度和既往抗尿失禁手术被确定为POP手术后持续性UI的危险因素。我们发现在任何一个腔室进行手术后尿失禁情况都有所减轻。
