Ismail Salima, Chartier-Kastler Emmanuel, Reus Christine, Cohen Jérémy, Seisen Thomas, Phé Véronique
Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Université, Paris, France.
Medical School Sorbonne Université, Paris, France.
Int Urogynecol J. 2019 May;30(5):805-813. doi: 10.1007/s00192-018-3727-y. Epub 2018 Aug 1.
Synthetic tapes and meshes used for the treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can lead to complications that require additional surgical procedures. The objective of this study was to report the functional outcomes following tape/mesh removal procedures.
This retrospective study included all consecutive women who underwent a tape/mesh surgical revision in a single tertiary referral center from January 2008 to September 2016. Descriptive statistics were performed to assess outcomes.
Overall 140 women, with a mean age of 60.5 (range 35-91) years, had a tape/mesh surgical revision. Patients underwent the following surgeries: tape removal (n = 95/140, 67.9%), tape division (n = 23/140, 16.4%), mesh removal (n = 18/140, 12.9%) and concomitant tape and mesh removal (n = 4/140, 2.9%). Tape removals were mainly performed for voiding symptoms (n = 34/95, 35.8%) and vaginal erosion/extrusion (n = 16/95, 16.8%). Most mesh removals were performed for vaginal erosion/extrusion (n = 9/18, 50.0%). Mean interval between tape/mesh insertion and its surgical revision was 52.1 months (range 5.0 days-16.0 years). Mean follow-up time was 20.4 months (range 6.0 days-7.8 years). Voiding and storage symptoms resolved completely in 37/59 (62.7%) patients and in 14/37 (37.8%) patients, respectively; 42/81 (51.9%) patients with postoperative SUI recurrence or persistence underwent an additional surgical procedure. Among the 18 patients who had a mesh removal, only 1 (5.6%) had POP recurrence.
Although most symptoms resolved after tape and mesh surgical revisions, patients must be informed that symptoms may persist. Recurrent or persistent SUI or POP may require a subsequent surgical procedure.
用于治疗压力性尿失禁(SUI)和盆腔器官脱垂(POP)的合成胶带和网片可能会导致需要额外手术的并发症。本研究的目的是报告胶带/网片移除手术后的功能结果。
这项回顾性研究纳入了2008年1月至2016年9月在单一三级转诊中心接受胶带/网片手术翻修的所有连续女性患者。进行描述性统计以评估结果。
共有140名女性接受了胶带/网片手术翻修,平均年龄为60.5岁(范围35 - 91岁)。患者接受了以下手术:胶带移除(n = 95/140,67.9%)、胶带分割(n = 23/140,16.4%)、网片移除(n = 18/140,12.9%)以及胶带和网片联合移除(n = 4/140,2.9%)。胶带移除主要针对排尿症状(n = 34/95,35.8%)和阴道侵蚀/挤出(n = 16/95,16.8%)。大多数网片移除是因为阴道侵蚀/挤出(n = 9/18,50.0%)。胶带/网片植入与手术翻修之间的平均间隔时间为52.1个月(范围5.0天 - 16.0年)。平均随访时间为20.4个月(范围6.0天 - 7.8年)。排尿和储尿症状分别在37/59(62.7%)和14/37(37.8%)的患者中完全缓解;42/81(51.9%)术后SUI复发或持续存在的患者接受了额外的手术。在18名接受网片移除的患者中,只有1名(5.6%)出现POP复发。
尽管大多数症状在胶带和网片手术翻修后得到缓解,但必须告知患者症状可能会持续存在。复发性或持续性SUI或POP可能需要后续手术。