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确定接受盆腔器官脱垂手术的女性新发压力性尿失禁的危险因素和特征:一项系统评价。

Determining the risk factors and characteristics of de novo stress urinary incontinence in women undergoing pelvic organ prolapse surgery: A systematic review.

作者信息

Moosavi Seyyde Yalda, Samad-Soltani Taha, Hajebrahimi Sakineh, Sadeghi-Ghyassi Fatemeh, Pashazadeh Fariba, Abolhasanpour Nasrin

机构信息

Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.

Research Center for Evidence-Based Medicine: A JBI Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Turk J Urol. 2020 Nov;46(6):427-435. doi: 10.5152/tud.2020.20291. Epub 2020 Sep 22.

Abstract

OBJECTIVE

Stress urinary incontinence (SUI) is a common problem in women that affects their quality of life. According to the current evidence, 15%-50% of severe pelvic organ prolapse (POP) surgeries lead to de novo urinary incontinence (UI). This study aimed at determining the risk factors and characteristics of de novo SUI after POP surgeries in a systematic review.

MATERIAL AND METHODS

We conducted a systematic search of articles in English related to the risk of UI after POP surgery published until December 2019 in the selected bibliographic databases, including PubMed, EMBASE, Scopus, Cochrane Library, and ProQuest.

RESULTS

The initial search resulted in 2,363 studies, and after reviewing the titles and abstracts, 146 studies were identified. Moreover, 2 independent reviewers, using the Joanna Briggs Institute checklists, evaluated the risk of biases in the selected studies. Finally, 40 studies met the inclusion criteria. The most important predictors of UI after POP surgery were positive pessary testing, age >50 years, and maximum urethral closure pressure (MUCP) <60 cmHO.

CONCLUSION

Positive pessary testing, older age, and low MUCP were the most important risk factors for de novo incontinence after POP surgeries.

摘要

目的

压力性尿失禁(SUI)是影响女性生活质量的常见问题。根据现有证据,15% - 50%的严重盆腔器官脱垂(POP)手术会导致新发尿失禁(UI)。本系统评价旨在确定POP手术后新发SUI的危险因素和特征。

材料与方法

我们在选定的文献数据库(包括PubMed、EMBASE、Scopus、Cochrane图书馆和ProQuest)中,对截至2019年12月发表的与POP手术后UI风险相关的英文文章进行了系统检索。

结果

初步检索得到2363项研究,在审阅标题和摘要后,确定了146项研究。此外,2名独立评审员使用乔安娜·布里格斯研究所的清单评估了所选研究中的偏倚风险。最后,40项研究符合纳入标准。POP手术后UI的最重要预测因素是子宫托试验阳性、年龄>50岁和最大尿道闭合压(MUCP)<60 cmH₂O。

结论

子宫托试验阳性、年龄较大和MUCP较低是POP手术后新发尿失禁的最重要危险因素。

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本文引用的文献

1
The Use of a Vaginal Pessary to Decide Whether a Mid Urethral Sling should be Added to Prolapse Surgery.
J Urol. 2020 Mar;203(3):598-603. doi: 10.1097/JU.0000000000000575. Epub 2019 Oct 4.
2
The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery.
Int Urogynecol J. 2019 Jul;30(7):1119-1124. doi: 10.1007/s00192-018-03864-y. Epub 2019 Jan 14.
3
External validation of de novo stress urinary incontinence prediction model after vaginal prolapse surgery.
Int Urogynecol J. 2019 Oct;30(10):1719-1723. doi: 10.1007/s00192-018-3805-1. Epub 2018 Nov 15.
6
Retrospective study on de novo postoperative urinary incontinence after pelvic organ prolapse surgery.
Eur J Obstet Gynecol Reprod Biol. 2017 Dec;219:10-14. doi: 10.1016/j.ejogrb.2017.10.002. Epub 2017 Oct 4.
10
A Proximal Straining Mesh Location Is Associated With De Novo Stress Urinary Incontinence After Transobturator Mesh Procedures.
J Ultrasound Med. 2017 Mar;36(3):539-545. doi: 10.7863/ultra.16.03044. Epub 2017 Jan 21.

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