Lau Hui-Hsuan, Enkhtaivan Sugarmaa, Su Tsung-Hsien, Huang Wen-Chu
Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan.
Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan.
J Clin Med. 2019 Jul 25;8(8):1099. doi: 10.3390/jcm8081099.
: Being overweight or obese is a risk factor for incontinence and has negative impacts on the surgical outcomes. Compared with trans-obturator sling (TOS), single incision sling (SIS) is a new generation of anti-incontinence surgery. However, the data on SIS in overweight and obese women remains limited. : This retrospective study analyzed the objective and subjective cure rate of overweight and obese women who underwent sling surgeries. Other evaluations included valid questionnaires to assess quality of life and 1-hour pad test to quantify urine leakage. Surgical characteristics and adverse events were also analyzed. : A total of 217 patients were analyzed with a median follow-up period of 37.3 months (range, 9-84 months). For overweight and obese patients, the objective and subjective cure rate were comparable (all > 0.05). However, the SIS group had worse post-operative incontinence-related symptom distress ( < 0.001) and 1-hour pad test ( = 0.047). On the other hand, SIS had a shorter surgery time ( = 0.017) and lower pain score ( < 0.001). : Compared with TOS, SIS had non-significant cure rates in the overweight and obese women. SIS had worse urine leakage and incontinence symptoms, but less surgical and wound pain in obese women. Thorough pre-operative counseling is necessary.
超重或肥胖是尿失禁的一个风险因素，并且对手术结果有负面影响。与经闭孔吊带术（TOS）相比，单切口吊带术（SIS）是新一代的抗尿失禁手术。然而，关于超重和肥胖女性接受SIS手术的数据仍然有限。
这项回顾性研究分析了接受吊带手术的超重和肥胖女性的客观和主观治愈率。其他评估包括用于评估生活质量的有效问卷以及用于量化尿液泄漏的1小时尿垫试验。还分析了手术特征和不良事件。
总共分析了217例患者，中位随访期为37.3个月（范围9 - 84个月）。对于超重和肥胖患者，客观和主观治愈率相当（均>0.05）。然而，SIS组术后尿失禁相关症状困扰更严重（<0.001），1小时尿垫试验结果更差（=0.047）。另一方面，SIS手术时间更短（=0.017），疼痛评分更低（<0.001）。
与TOS相比，SIS在超重和肥胖女性中的治愈率无显著差异。SIS在肥胖女性中尿液泄漏和尿失禁症状更严重，但手术和伤口疼痛更少。术前进行全面的咨询是必要的。
