Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA.
Department of Urology, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA.
Int Urogynecol J. 2022 Apr;33(4):821-828. doi: 10.1007/s00192-021-04737-7. Epub 2021 Mar 12.
The objective was to report on the very long-term outcome of a published series of autologous pubovaginal slings (PVS) in women with stress urinary incontinence (SUI).
Following institutional review board approval, a cohort of well characterized, non-neurogenic women who underwent an autologous PVS (primary [PVS1] and secondary [PVS2]) for SUI was re-evaluated for their very long-term outcome status. Data collected included demographics, validated questionnaires (Urogenital Distress Inventory - short form [UDI-6], Incontinence Impact Questionnaire - short form 7, quality of life), SUI retreatment/operations, and subjective patient-reported SUI improvement (%) and symptom recurrence. The primary outcome was success defined as UDI-6 question 3 (SUI) ≤ 1 and no SUI retreatment/operation. Patients not seen in clinic for 2 years were contacted via a standardized phone interview.
From 83 patients with 7-year intermediate follow-up data, 34 (PVS1 = 18, PVS2 = 16) had very long-term follow-up based on clinic visit (7) or phone interviews (27). Those lost to follow-up (49), including 5 deceased, did not differ in demographics and intermediate outcomes from the followed cohort, but lived further away (>75 miles). At a mean age of 74 years, and with a median follow-up of 14.5 years, 53% met the success criteria (PVS1 = 44%, PVS2 = 63%). Mean postoperative questionnaire scores did not differ significantly between intermediate and very long-term follow-ups, and long-term outcomes between PVS1 and PVS2 remained similar.
A majority of women with long-term follow-up after PVS for primary and secondary SUI remained successful more than 14 years after their surgery. Both groups, PVS1 and PVS2, fared equally well, confirming the durability of PVS as a treatment alternative for SUI.
本研究旨在报告已发表的一系列自体耻骨阴道吊带（PVS）治疗女性压力性尿失禁（SUI）的非常长期结局。
经机构审查委员会批准，对一组经自体 PVS（原发性 [PVS1] 和继发性 [PVS2]）治疗 SUI 的特征明确的非神经源性女性进行了重新评估，以了解其非常长期结局状况。收集的数据包括人口统计学资料、经过验证的问卷（尿失禁生活质量问卷-短表[UDI-6]、尿失禁影响问卷-短表 7、生活质量）、SUI 再治疗/手术以及主观患者报告的 SUI 改善（%）和症状复发。主要结局定义为 UDI-6 问题 3（SUI）≤1 和无 SUI 再治疗/手术。对于 2 年内未在诊所就诊的患者，通过标准化电话访谈进行联系。
在 83 例具有 7 年中期随访数据的患者中，根据门诊就诊（7 例）或电话访谈（27 例），有 34 例（PVS1=18 例，PVS2=16 例）获得了非常长期随访。在随访队列中，失去随访的 49 例患者（包括 5 例死亡）在人口统计学资料和中期结局方面与随访队列无差异，但居住距离更远（>75 英里）。在平均年龄为 74 岁、中位随访时间为 14.5 年时，有 53%的患者达到了成功标准（PVS1=44%，PVS2=63%）。中期和非常长期随访的术后问卷评分无显著差异，PVS1 和 PVS2 的长期结局相似。
在接受原发性和继发性 SUI 的 PVS 治疗后进行长期随访的大多数女性在手术后 14 年以上仍保持成功。两组，PVS1 和 PVS2，表现相当，证实了 PVS 作为 SUI 治疗替代方案的耐久性。
