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经闭孔尿道中段悬吊术前尿动力学研究对术后尿控效果的影响。

Effect of Preoperative Urodynamic Study on Urinary Outcomes after Transobturator Sling.

机构信息

Hospital Universitário de Brasília, Brasília, DF, Brazil.

Hospital de Base do Distrito Federal, Brasília, DF, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2021 Feb;43(2):131-136. doi: 10.1055/s-0040-1719148. Epub 2021 Jan 19.

Abstract

OBJECTIVE

To evaluate whether performing preoperative urodynamic study influences postoperative urinary symptoms of women with stress urinary incontinence that underwent transobturator sling.

METHODS

Retrospective analysis of patients treated for stress urinary incontinence by transobturator sling from August 2011 to October 2018. Predictor variables included preoperative urodynamic study, age, incontinence severity, body mass index, preoperative storage symptoms and previous anti-urinary incontinence procedure. Outcome variables were postoperative subjective continence status, storage symptoms and complications. Logistic regression after propensity score was employed to compare outcomes between patients who underwent or not pre-operative urodynamic study.

RESULTS

The present study included 88 patients with an average follow-up of 269 days. Most patients ( 52; 59.1%) described storage symptoms other than stress urinary incontinence, and 38 patients (43.2%) underwent preoperative urodynamic studies. Logistic regression after propensity score did not reveal an association between urinary continence outcomes and performance of preoperative urodynamic study (odds ratio 0.57; confidence interval [CI]: 0.11-2.49). Among women that did not undergo urodynamic study, there was a subjective improvement in urinary incontinence in 92% of the cases versus 87% in those that underwent urodynamic study ( = 0.461). Furthermore, postoperative storage symptoms were similar between women who did not undergo urodynamic study and those who underwent urodynamic study, 13.2% versus 18.4%, respectively ( = 0.753).

CONCLUSION

Preoperative urodynamic study had no impact on urinary incontinence cure outcomes as well as on urinary storage symptoms after the transobturator sling in women with stress urinary incontinence.

摘要

目的

评估女性压力性尿失禁行经闭孔吊带术前行尿动力学检查是否影响术后尿失禁症状。

方法

回顾性分析 2011 年 8 月至 2018 年 10 月因压力性尿失禁行经闭孔吊带术的患者。预测变量包括术前尿动力学检查、年龄、尿失禁严重程度、体重指数、术前储尿症状和既往抗尿失禁治疗。结果变量为术后主观控尿状况、储尿症状和并发症。采用倾向评分后逻辑回归比较行与不行术前尿动力学检查患者的结局。

结果

本研究共纳入 88 例患者,平均随访 269 天。大多数患者(52 例,59.1%)除压力性尿失禁外还有其他储尿症状,38 例(43.2%)患者行术前尿动力学检查。经倾向评分后逻辑回归分析,尿控结局与行术前尿动力学检查之间无相关性(比值比 0.57;95%置信区间:0.11-2.49)。未行尿动力学检查的患者中,92%的患者主观上尿失禁得到改善,而行尿动力学检查的患者中 87%的患者主观上尿失禁得到改善( = 0.461)。此外,未行尿动力学检查的患者与行尿动力学检查的患者术后储尿症状相似,分别为 13.2%和 18.4%( = 0.753)。

结论

术前尿动力学检查对女性压力性尿失禁行经闭孔吊带术后的尿失禁治愈率和储尿症状无影响。

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