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在接受全腹腔镜子宫切除术的患者中,哪种抗失禁手术更好?Burch 阴道悬吊术还是经闭孔吊带术?

Which Anti-Incontinence Surgery Option is Better in Patients Undergoing Total Laparoscopic Hysterectomy? Burch Colposuspension or Transobturator Tape Procedure.

机构信息

Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 Jun;249:59-63. doi: 10.1016/j.ejogrb.2020.04.039. Epub 2020 Apr 18.

DOI:10.1016/j.ejogrb.2020.04.039
PMID:32361330
Abstract

OBJECTIVES

Stress urinary incontinence (SUI) surgery and hysterectomy are often performed in the same session. The aim of this study was to determine which urinary incontinence surgery would be a better option for patients who would undergo a hysterectomy for various indications.

STUDY DESIGN

This retrospective study included 65 patients who had undergone total laparoscopic hysterectomy and anti-incontinence surgery (TOT or Burch).A retrospective chart review was performed to record the patient data including demographic features, duration of operations, postoperative complete blood count values and post-void residual urine volumes. ICIQ-UI and UDI-6 interrogations related to urinary incontinence were compared pre- and postoperatively between two groups.

RESULTS

There was no difference in demographic characteristics and menopausal status between groups. No significant difference was found between two groups in postoperative period for urinary incontinence scores (p>0,05). When the duration of operation was compared, the duration was significantly higher in the TOT group. And the hematocrit drop in the group with TOT was significantly higher (p<0.05).

CONCLUSIONS

Because the success rates of Burch colposuspension and transobturator procedures are similar, either of these two methods can be selected according to patient characteristics and surgeon experience. But Burch colposuspension seems to be more preferable in terms of blood loss and operation time than TOT.

摘要

目的

压力性尿失禁(SUI)手术和子宫切除术通常在同一时间进行。本研究旨在确定对于因各种原因需要接受子宫切除术的患者,哪种尿失禁手术是更好的选择。

研究设计

本回顾性研究纳入了 65 名接受全腹腔镜子宫切除术和抗失禁手术(TOT 或 Burch)的患者。对病历进行回顾性分析,记录患者的人口统计学特征、手术时间、术后全血细胞计数值和残余尿量。比较两组患者术前和术后的 ICIQ-UI 和 UDI-6 尿失禁问卷。

结果

两组患者的人口统计学特征和绝经状态无差异。两组患者术后尿失禁评分无显著差异(p>0.05)。当比较手术时间时,TOT 组的手术时间明显更长。TOT 组的血细胞比容下降明显更高(p<0.05)。

结论

由于 Burch 阴道悬吊术和经闭孔手术的成功率相似,可根据患者特征和外科医生经验选择这两种方法中的任何一种。但就出血量和手术时间而言,Burch 阴道悬吊术似乎优于 TOT。

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