Department of Surgery, Maria Middelares, Buitenring Sint-Denijs 30, 9000, Ghent, Belgium.
Department of Urology, Maria Middelares, Ghent, Belgium.
Surg Endosc. 2020 Feb;34(2):920-929. doi: 10.1007/s00464-019-06850-7. Epub 2019 May 28.
Laparoscopic bilateral inguinal hernia repair may be completed with one large self-fixating mesh crossing the midline. No studies have investigated in detail whether preperitoneal mesh placement induces temporary or more lasting urinary symptoms.
Urinary and hernia-related symptoms were evaluated preoperatively and postoperatively at 1, 3 and 12 months using the ICIQ-MLUTS questionnaire and EuraHS-QoL score in patients undergoing bilateral inguinal hernia repair.
One hundred patients were included. Voiding symptoms and bother scores were unchanged at 1 or 3 months, but there was significant improvement at 12 months compared with preoperative findings (symptoms P < 0.001; bother score P < 0.01). Incontinence symptoms improved at 1 month (P < 0.05) but not at 3 or 12 months, with a bother score significantly improved at 1 month (P < 0.01) and 12 months (P < 0.01). Diurnal and nocturnal frequency did not change significantly postoperatively, but 12 months nocturnal bother score was decreased (P < 0.05). EuraHS-QoL scores showed statistical significant improvement in all three domains for all measurements at the different follow-up moments compared to previous measurements. Postoperative symptoms were improved at 12 months, compared with preoperative pain scores (- 6.1), restriction of activity (- 10.1) and cosmetic scores (- 4.7) These findings were statistically significant (P < 0.001). At 12 months, there were no patients with severe discomfort (score ≥ 5) for any of the three domains. No recurrences were diagnosed with 95% clinical follow-up at 12 months.
Laparoscopic bilateral groin hernia repair with one large preperitoneal self-fixating mesh did not cause new urinary symptoms and demonstrated significant improvement in voiding symptoms at 12 months. Incontinence and nocturnal bother score were significantly improved.
Clinical.Trials.gov: NCT02525666.
腹腔镜双侧腹股沟疝修补术可以使用一块大的自固定网片横跨中线完成。目前尚无研究详细探讨腹膜前补片放置是否会引起暂时或更持久的尿症状。
使用 ICIQ-MLUTS 问卷和 EuraHS-QoL 评分，在接受双侧腹股沟疝修补术的患者中，分别于术前、术后 1、3 和 12 个月评估尿和疝相关症状。
共纳入 100 例患者。1 或 3 个月时排尿症状和困扰评分无变化，但与术前相比，12 个月时明显改善（症状 P<0.001；困扰评分 P<0.01）。1 个月时失禁症状改善（P<0.05），但 3 个月和 12 个月时无改善，1 个月（P<0.01）和 12 个月（P<0.01）时困扰评分明显改善。日间和夜间频率术后无明显变化，但 12 个月时夜间困扰评分降低（P<0.05）。EuraHS-QoL 评分显示，与术前相比，所有三个领域在所有随访时间点的测量值均有统计学意义的改善。与术前疼痛评分（-6.1）、活动受限评分（-10.1）和美容评分（-4.7）相比，术后 12 个月时症状得到改善，这些发现具有统计学意义（P<0.001）。在 12 个月时，没有任何一位患者在三个领域的任何一个方面出现严重不适（评分≥5）。95%的临床随访 12 个月时未发现复发。
腹腔镜双侧腹股沟疝修补术使用一块大的腹膜前自固定网片不会引起新的尿症状，并在 12 个月时显著改善排尿症状。在 12 个月时，失禁和夜间困扰评分明显改善。
Clinical.Trials.gov：NCT02525666。
