Rechberger Ewa, Skorupska Katarzyna, Rechberger Tomasz, Wojtaś Małgorzata, Miotła Paweł, Kulik-Rechberger Beata, Wróbel Andrzej
Second Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.
Department of Paediatric Propedeutics, Medical University of Lublin, Gębali 6, 20-093 Lublin, Poland.
J Clin Med. 2020 Mar 18;9(3):829. doi: 10.3390/jcm9030829.
The aim of this study was to assess the effectiveness of vaginal native tissue repair (VNTR) on preexisting Lower Urinary Tract Symptoms (LUTS) in women with symptomatic pelvic organ prolapse (POP). Two hundred patients who underwent VNTR for symptomatic POP from January 2018 to February 2019 were followed up for 6 months. All patients underwent VNTR, but in the posterior compartment, the rectovaginal fascia was reconnected to the uterosacral ligaments and additionally sutured to the iliococcygeus fascia and muscle. To assess the severity and change in storage phase LUTS before and after surgery, all participants were asked to complete 3 questionnaires: the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), Urogenital Distress Inventory-6 (UDI-6), and Incontinence Impact Questionnaire-7 (IIQ-7). The data were assessed with Statistica package version 12.0, using Kalmogorow-Smirnoff, W Shapiro-Wilk tests. Furthermore, one-way analysis of variance was applied with post-hoc Tukey test. The study results indicate that the majority of patients with advanced POP suffered from various LUTS. Among storage symptoms, the occurrence of urinary incontinence (UI) and urgency decreased significantly after surgery. Moreover, ICIQ-SF, UDI-6, and IIQ-7 results showed statistically significant improvement in the impact of UI on the quality of life (QoL) in the vast majority of patients after surgery. VNTR is an effective way to treat not only anatomical, but also functional problems in such patients.
本研究的目的是评估阴道原生组织修复（VNTR）对有症状盆腔器官脱垂（POP）女性既往存在的下尿路症状（LUTS）的有效性。对2018年1月至2019年2月因有症状POP接受VNTR的200例患者进行了6个月的随访。所有患者均接受了VNTR，但在后盆腔，直肠阴道筋膜重新连接至骶子宫韧带，并额外缝合至髂尾肌筋膜和肌肉。为了评估手术前后储尿期LUTS的严重程度和变化，所有参与者被要求完成3份问卷：国际尿失禁咨询问卷简表（ICIQ-SF）、泌尿生殖系统困扰量表-6（UDI-6）和尿失禁影响问卷-7（IIQ-7）。使用Statistica 12.0软件包，通过Kalmogorow-Smirnoff检验和W Shapiro-Wilk检验对数据进行评估。此外，应用单因素方差分析及事后Tukey检验。研究结果表明，大多数晚期POP患者存在各种LUTS。在储尿期症状中，术后尿失禁（UI）和尿急的发生率显著降低。此外，ICIQ-SF、UDI-6和IIQ-7结果显示，术后绝大多数患者UI对生活质量（QoL）的影响有统计学意义的改善。VNTR不仅是治疗此类患者解剖问题，也是治疗功能问题的有效方法。
