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经阴道单切口网片置入盆底重建术后新发压力性尿失禁的预测因素。

Predictors for de novo stress urinary incontinence following pelvic reconstruction surgery with transvaginal single-incisional mesh.

机构信息

Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.

Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Sci Rep. 2019 Dec 16;9(1):19166. doi: 10.1038/s41598-019-55512-0.

Abstract

The study aims to identify predictors for de novo stress urinary incontinence (SUI) following Elevate mesh surgery. A total of 164 women who underwent Elevate mesh surgeries between November 2011 and February 2014 in a single center were included. Seventy-three women were excluded due to preoperative incontinence or concomitant mid-urethral sling surgery. Fourteen others were excluded due to incomplete medical records. Fisher's exact test and χ test were applied. The univariate logistic regression was used for odds ratios. Of the 77 continent women, 24 (31.2%) experienced de novo SUI after the operation. Significantly more women with de novo SUI were over the age of 64 years (75.0% vs. 47.2%, p = 0.023, OR 3.36, 95% CI 1.15-9.79). Preoperative occult urodynamic stress incontinence (29.2% vs. 3.8%, p = 0.003, OR 10.0, 95% CI 2.0-50.0) and previous SUI history (41.7% vs. 7.6%, p = 0.001, OR 9.1, 95% CI 2.38-33.3) were 2 other predictors of de novo SUI postoperatively. In conclusion, age over 64 years old, occult urodynamic stress incontinence, and previous history of SUI are 3 significant predictors for de novo SUI following the single-incision mesh surgeries.

摘要

本研究旨在确定 Elevate 网片手术后新发压力性尿失禁(SUI)的预测因素。共有 164 名女性在单中心接受 Elevate 网片手术,其中 73 名因术前尿失禁或同时行中段吊带手术而被排除,另有 14 名因病历不完整而被排除。采用 Fisher 确切检验和 χ 检验。单变量逻辑回归用于计算比值比。在 77 名无尿失禁的女性中,24 名(31.2%)在手术后出现新发 SUI。新发 SUI 的女性中,64 岁以上的比例明显更高(75.0% vs. 47.2%,p=0.023,OR 3.36,95%CI 1.15-9.79)。术前隐匿性尿动力学压力性尿失禁(29.2% vs. 3.8%,p=0.003,OR 10.0,95%CI 2.0-50.0)和既往 SUI 病史(41.7% vs. 7.6%,p=0.001,OR 9.1,95%CI 2.38-33.3)是术后新发 SUI 的另外 2 个预测因素。总之,64 岁以上、隐匿性尿动力学压力性尿失禁和既往 SUI 病史是单切口网片手术后新发 SUI 的 3 个重要预测因素。

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