Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan (ROC).
Department of Obstetrics and Gynecology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan (ROC).
Low Urin Tract Symptoms. 2021 Jul;13(3):341-346. doi: 10.1111/luts.12373. Epub 2021 Mar 11.
This study aimed to assess the short-term results of stress urinary incontinence (SUI) in women undergoing laparoscopic sacrocolpopexy (LSC) with and without midurethral sling (MUS).
This retrospective study was conducted from July 2012 to December 2017. Women with stage 3 or 4 in the Pelvic Organ Prolapse Quantification (POP-Q) who underwent LSC were recruited. Multichannel urodynamic studies were performed in all women. Assessment included pre- and postoperative POP-Q stages, urodynamic parameters, peri- and postoperative complications, and symptoms.
One hundred and eighteen patients met the inclusion criteria in total. A total of 19.5% (23/118) of them had concomitant MUS. The mean follow-up duration was 16.9 ± 16.0 (range 3-69) months. Meanwhile, 33.9% (40/118) of the patients were diagnosed with overt SUI, and 50% (20/40) underwent MUS. In the concomitant MUS group, the rate of having postoperative SUI was only 5% (1/20). Patients diagnosed with SUI and without concomitant MUS had a 45% rate (9/20), and 25% of them (5/20) received MUS later. Preoperatively, 16.1% (19/118) of the patients were diagnosed with occult SUI. Among the patients without anti-incontinence sling during prolapse surgery, 25% (4/16) of them complained about having SUI during the follow-up. However, none of the women required subsequent anti-incontinence surgery. Postoperative de novo SUI occurred to 13.6% (16/118) of them. None of the patients received further operation. Based on the preoperative and postoperative urodynamic studies in the combination surgery group, a significant improvement was observed in the pad test.
The combination of LSC with MUS procedure is likely to be beneficial in selected patients.
本研究旨在评估腹腔镜骶骨阴道固定术（LSC）联合和不联合中段尿道悬吊带（MUS）治疗女性压力性尿失禁（SUI）的短期疗效。
这是一项回顾性研究，于 2012 年 7 月至 2017 年 12 月进行。招募了在盆腔器官脱垂定量（POP-Q）中处于第 3 或 4 阶段并接受 LSC 的女性。所有女性均进行多通道尿动力学检查。评估包括术前和术后 POP-Q 阶段、尿动力学参数、围手术期并发症和症状。
共有 118 名患者符合纳入标准。其中共有 19.5%（23/118）的患者同时合并 MUS。平均随访时间为 16.9±16.0（范围 3-69）个月。同时，33.9%（40/118）的患者被诊断为显性 SUI，其中 50%（20/40）接受了 MUS。在同时合并 MUS 的患者中，术后发生 SUI 的比例仅为 5%（1/20）。未合并 MUS 的 SUI 患者中有 45%（9/20）的患者需要 MUS，其中 25%（5/20）的患者随后接受了 MUS。术前，16.1%（19/118）的患者被诊断为隐匿性 SUI。在脱垂手术中未接受抗失禁吊带的患者中，25%（4/16）的患者在随访期间出现 SUI。然而，没有女性需要进一步的抗失禁手术。术后新发 SUI 发生率为 13.6%（16/118）。没有患者接受进一步的手术。在联合手术组中，基于术前和术后尿动力学研究，垫试验显著改善。
在选择的患者中，LSC 联合 MUS 手术可能是有益的。
