两种中段尿道吊带手术治疗压力性尿失禁后尿路感染的患病率及危险因素。
Prevalence and risk factors for urinary tract infection following stress urinary incontinence surgery with two midurethral sling procedures.
机构信息
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Division of Community Health, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
出版信息
Int J Gynaecol Obstet. 2018 Dec;143(3):333-338. doi: 10.1002/ijgo.12680. Epub 2018 Oct 1.
OBJECTIVE
To compare prevalence and risk factors for urinary tract infection (UTI) following midurethral sling surgery with either the GYNECARE ABBREVO Continence System (Ethicon, Somerville, NJ, USA) or a standard transobturator.
METHODS
A retrospective cohort study was conducted among women who underwent midurethral sling surgery to treat stress urinary incontinence at a single tertiary hospital in Israel between January 1, 2014, and August 11, 2015. Data were retrieved from medical records. The diagnosis of UTI was based on a positive urine culture result.
RESULTS
Of 178 patients included, 30 (16.9%) underwent the ABBREVO procedure and 148 (83.1%) underwent the standard transobturator procedure. The mean ± SD BMI at the time of surgery was 28.1 ± 4.5 for the standard transobturator procedures and 30.7 ± 15.2 for the ABBREVO procedures. Women who underwent the ABBREVO procedure had an increased duration of hospitalization (P=0.004), and higher rates of concomitant anterior colporrhaphy procedures (P=0.009) and concomitant hysterectomy (P=0.009). Only 38 (21.3%) women developed UTIs within 12 months of surgery (seven in the ABBREVO procedure group and 31 in the standard transobturator procedure group). No statistically significant between-group differences were found for the risk of UTI or for urinary tract adverse events, such as recurrent UTI and the need for rehospitalization.
CONCLUSIONS
The two procedures were comparable in terms of prevalence and risk factors for UTI during the postoperative period.
目的
比较经阴道尿道中段吊带术（GYNECARE ABBREVO 尿失禁系统[Ethicon，新泽西州 Somerville]与标准经闭孔吊带术治疗女性压力性尿失禁术后发生尿路感染（UTI）的患病率和危险因素。
方法
本研究为单中心回顾性队列研究，纳入 2014 年 1 月 1 日至 2015 年 8 月 11 日期间在以色列一家三级医院接受经阴道尿道中段吊带术治疗压力性尿失禁的女性患者。研究数据来源于病历。UTI 的诊断基于阳性尿液培养结果。
结果
本研究共纳入 178 例患者，其中 30 例（16.9%）接受 ABBREVO 手术，148 例（83.1%）接受标准经闭孔吊带术。标准经闭孔吊带术组和 ABBREVO 组的平均 BMI（±标准差）分别为 28.1±4.5 和 30.7±15.2。接受 ABBREVO 手术的患者住院时间更长（P=0.004），同期行前阴道修补术（P=0.009）和同期行子宫切除术（P=0.009）的比例更高。术后 12 个月内，仅有 38 例（21.3%）女性发生 UTI（ABBREVO 组 7 例，标准经闭孔吊带术组 31 例）。两组间 UTI 或尿路感染不良事件（如复发性 UTI 和需要再次住院）的风险无统计学差异。
结论
在术后期间，这两种手术方法在 UTI 的患病率和危险因素方面相似。
Zotero 插件