Department of Urogynaecology, Queen Elizabeth University Hospital, Glasgow, Scotland.
World J Urol. 2021 Jun;39(6):2107-2112. doi: 10.1007/s00345-020-03413-7. Epub 2020 Aug 20.
Urethral bulking agents (UBA) have traditionally been offered as salvage procedures for recurrent stress urinary incontinence (SUI). We compare the success of UBA in patients that had undergone a previous procedure for SUI (Salvage-UBA) to the SUI surgery naïve (Primary-UBA). We hypothesised a positive effect in both Primary and Salvage-UBA with potentially poorer rates of response in the salvage group.
Retrospective case series of patients having their first UBA (2010-2018). Primary outcome was to assess any difference in patient reported success between groups. Patient-reported improvement was assessed on a 4-point scale: 'cured, improved, no change, worse' and treatment 'success' defined as 'cured' or 'improved'. A multivariate analysis, adjusting for plausible differences between groups, was undertaken in IBM SPSS Statistics (2016).
135 Primary-UBA and 38 Salvage-UBA were performed. Complete follow-up was obtained for 114 patients (66%): 86 Primary and 28 Salvage. Median follow-up time: 33 months. In 2012, 47% (8/17) of all UBA were Salvage-UBA, whilst in 2018, the majority were Primary-UBA (92%, 46/50). Success was not significantly different between Salvage-UBA 75% (21/28) versus Primary-UBA 67% (58/86) (Wald χ = 0.687, df = 1, p = 0.407). Top-up rates were similar: 14% (n = 4/28, Salvage-UBA) versus 15% (n = 13/86, Primary-UBA) (χ = 0.011, df = 1, p = 0.914).
The number of women opting for UBA has increased substantially. No significant differences were noted for success with Salvage-UBA compared to Primary-UBA.
尿道填充剂（UBA）传统上被作为复发性压力性尿失禁（SUI）的补救治疗方法。我们比较了先前接受过 SUI 手术（补救性 UBA）和初次接受 SUI 手术（原发性 UBA）的患者中 UBA 的成功率。我们假设原发性和补救性 UBA 都会有积极的效果，但在补救组中，反应的可能性较差。
对 2010 年至 2018 年间首次接受 UBA 的患者进行回顾性病例系列研究。主要结局是评估两组患者报告的成功率有无差异。患者报告的改善情况采用 4 分制进行评估：“治愈、改善、无变化、恶化”，治疗“成功”定义为“治愈”或“改善”。在 IBM SPSS Statistics（2016）中进行了调整组间可能差异的多变量分析。
共进行了 135 例原发性 UBA 和 38 例补救性 UBA。114 例患者（66%）获得了完整的随访：86 例原发性和 28 例补救性。中位随访时间：33 个月。2012 年，所有 UBA 的 47%（8/17）为补救性 UBA，而 2018 年，大多数为原发性 UBA（92%，46/50）。补救性 UBA 的成功率为 75%（28/28），原发性 UBA 的成功率为 67%（58/86），两组间无显著差异（Wald χ=0.687，df=1，p=0.407）。追加治疗率相似：14%（n=4/28，补救性 UBA）与 15%（n=13/86，原发性 UBA）（χ=0.011，df=1，p=0.914）。
选择 UBA 的女性人数大幅增加。与原发性 UBA 相比，补救性 UBA 的成功率无显著差异。
