Grison P, Tixier S, Descamps P, Bigot P, Catala L, Legendre G
Service d'urologie, CHU Angers, 4, rue Larrey, 49100 Angers, France.
Service de gynécologie obstétrique, CHU Angers, 4, rue Larrey, 49100 Angers, France.
Gynecol Obstet Fertil Senol. 2018 Nov;46(10-11):673-680. doi: 10.1016/j.gofs.2018.09.008. Epub 2018 Oct 6.
To compare the effectiveness of an ALTIS mini-sling and a conventionnal suburethral sling TVT-ABBREVO for treatment of female stress urinary incontinence.
A single-center retrospective study included all female patients fitted with a conventional transobturator tape (TVT-ABBREVO) or mini-sling (ALTIS), during 2015, in Angers university hospital. The success rate was defined by no urine leakage during a cough test on clinical examination, improved quality of life defined by a PGI-I (Patient Global Impression of Improvement) score of 1 to 3, and no stress urinary incontinence on USP (Urinary Symptom Profile) questionnaire. Morbidity associated with slings and perioperative data were also recorded.
Ninety-two patients were included (39 in the ALTIS group and 53 in the ABBREVO group). The average follow-up was 13.55 months. The success rate was not significantly different in ALTIS group for the negative cough test (89.7% vs 94.3% in ABBREVO group, P=0.45), for the absence of urinary leakage reported on the USP questionnaire (87.2% vs 90.6% in ABBREVO group, P=0.61), or for the improvement of the quality of life with a PGI-I score between 1 and 3 (82.1% vs 86.8% in ABBREVO group, P=0.53). On the other hand, more patients were fully satisfied, with a PGI-I quality of life score of 1, in ABBREVO group than in ALTIS group (67.9% compared with 46.2%, P=0.03). Immediate postoperative pain was significantly less intense in ALTIS group than in ABBREVO group (average VAS score of 0.5 comparated with 1.3, P=0.01), but this difference had disappeared one week after surgery. The rates of other complications were similar in both groups.
The functional results of the ALTIS and TVT-ABBREVO slings appear similar in the treatment of female stress urinary incontinence.
比较ALTIS迷你吊带与传统尿道下吊带TVT-ABBREVO治疗女性压力性尿失禁的疗效。
一项单中心回顾性研究纳入了2015年在昂热大学医院接受传统经闭孔尿道中段悬吊带术（TVT-ABBREVO）或迷你吊带（ALTIS）的所有女性患者。成功率的定义为临床检查咳嗽试验时无尿液渗漏、PGI-I（患者总体改善印象）评分为1至3所定义的生活质量改善以及USP（泌尿系统症状问卷）问卷中无压力性尿失禁。还记录了与吊带相关的发病率和围手术期数据。
纳入92例患者（ALTIS组39例，ABBREVO组53例）。平均随访时间为13.55个月。ALTIS组在咳嗽试验阴性方面的成功率（89.7%对比ABBREVO组的94.3%，P = 0.45）、USP问卷中报告无尿液渗漏方面（87.2%对比ABBREVO组的90.6%，P = 0.61）或PGI-I评分为1至3时生活质量改善方面（82.1%对比ABBREVO组的86.8%，P = 0.53）与ABBREVO组相比无显著差异。另一方面，ABBREVO组PGI-I生活质量评分为1的完全满意患者多于ALTIS组（67.9%对比46.2%，P = 0.03）。ALTIS组术后即刻疼痛明显轻于ABBREVO组（平均VAS评分为0.5对比1.3，P = 0.01），但术后一周这种差异消失。两组其他并发症发生率相似。
ALTIS和TVT-ABBREVO吊带在治疗女性压力性尿失禁方面的功能结果相似。
