Emami Maryam, Momtazan Abdolreza, Maghsoudi Robab, Ameli Mojtaba, Kashi Amirhosein, Amirpoor Minoo, Karimi Sara
1 Iran University of Medical Sciences, Tehran, Iran.
2 Gonabad University of Medical Sciences, Gonabad, Iran.
Urologia. 2019 Aug;86(3):152-155. doi: 10.1177/0391560319845255. Epub 2019 May 10.
Stress urinary incontinence is one of the most common types of incontinence in premenopausal women, accounting for almost 50% of such cases. Mid-urethral slings are currently the most widely used surgical method for stress urinary incontinence. This study aimed at comparing the efficacy, complications, urodynamic changes and the sexual function status between mini-sling surgery and transobturator tape to help us select the best method in such patients.
In this randomized controlled trial, 80 cases were studied and randomly assigned to either the mini-sling or transobturator tape group (n = 40). A full medical history was taken and the Q.tip and cough tests were performed for each patient to record their urinary incontinence and hypermobility. Abdominal and pelvic ultrasound study was requested by specifying PVR and urodynamic testing. The International Consultation on Incontinence Modular Questionnaire-6 was filled by the patients and the Female Sexual Functioning Index questionnaire by the physician. The patients were followed-up 8 weeks after discharge by urodynamic tests, ultrasound study, and the International Consultation on Incontinence Modular Questionnaire test.
The mean age, body mass index, and parity were not significantly different between the two groups. The mean surgical time, amount of bleeding, hospitalization period, and pain index were significantly less in the mini-sling group. The International Consultation on Incontinence Modular Questionnaire and Female Sexual Functioning Index indices before and after surgery showed no significant difference between the two groups. The difference in urodynamic test parameters was also insignificant.
In the mini-sling method which is a less invasive method compared to transobturator tape, the intraoperative bleeding, surgical time, hospitalization period, pain, and surgical complications were far less while its efficacy was similar to transobturator tape; therefore, it is recommended in treating stress urinary incontinence among women.
压力性尿失禁是绝经前女性最常见的尿失禁类型之一，几乎占此类病例的50%。中段尿道吊带术是目前治疗压力性尿失禁应用最广泛的手术方法。本研究旨在比较迷你吊带手术和经闭孔尿道中段吊带术的疗效、并发症、尿动力学变化及性功能状况，以帮助我们为此类患者选择最佳治疗方法。
在这项随机对照试验中，研究对象为80例患者，随机分为迷你吊带组或经闭孔尿道中段吊带组（n = 40）。记录每位患者完整的病史，并进行棉签试验和咳嗽试验以记录其尿失禁及尿道活动过度情况。要求进行腹部和盆腔超声检查，明确膀胱残余尿量（PVR）并进行尿动力学检测。患者填写国际尿失禁咨询委员会模块化问卷-6，医生填写女性性功能指数问卷。出院8周后对患者进行尿动力学检测、超声检查及国际尿失禁咨询委员会模块化问卷测试随访。
两组患者的平均年龄、体重指数和产次无显著差异。迷你吊带组的平均手术时间、出血量、住院时间和疼痛指数明显更低。两组手术前后的国际尿失禁咨询委员会模块化问卷和女性性功能指数指标无显著差异。尿动力学检测参数的差异也不显著。
与经闭孔尿道中段吊带术相比，迷你吊带术是一种侵入性较小的手术方法，术中出血、手术时间、住院时间、疼痛及手术并发症更少，而疗效与经闭孔尿道中段吊带术相似；因此，推荐用于治疗女性压力性尿失禁。
