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327 例压力性尿失禁患者中尿道吊带手术与非消融阴道铒:YAG 激光治疗的比较:病例匹配分析。

Comparison of urethral sling surgery and non-ablative vaginal Erbium:YAG laser treatment in 327 patients with stress urinary incontinence: a case-matching analysis.

机构信息

Urology, Kanagawa Dental University, Yokosuka, Kanagawa, Japan.

Urology, Dr Okui's Urogynecology and Urology, Yokosuka, Kanagawa, Japan.

出版信息

Lasers Med Sci. 2022 Feb;37(1):655-663. doi: 10.1007/s10103-021-03317-x. Epub 2021 Apr 22.

Abstract

Stress urinary incontinence (SUI) occurs when abdominal pressure, such as from coughing or sneezing, causes urine leakage. We retrospectively compared tension-free vaginal tape (TVT) and non-ablative vaginal Erbium:YAG laser treatment (VEL) by propensity score (PS) analysis in women with SUI. No PS analysis studies have investigated urethral sling surgery using polypropylene TVT and VEL for SUI. Data from patients aged 35-50 years who were treated for SUI and registered at several institutions were selected. Patients with medical records covering 1 year for the 1-h pad test, who completed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the Overactive Bladder Symptom Score (OABSS), were included. We analyzed 102, 113, and 112 patients in the TVT, VEL, and control groups, respectively. Compared with the control group, the TVT and VEL groups exhibited significant improvement in the 1-h pad test and ICIQ-SF. In the PS analysis, the TVT and VEL groups similarly improved in the 1-h pad test and ICIQ-SF. As for the OABSS, the VEL group showed significantly greater improvement than the TVT group. In the odds ratio analysis for the 1-h pad test, no differences in any of the parameters were observed between TVT and VEL. VEL may be considered an alternative to TVT for SUI treatment.

摘要

压力性尿失禁 (SUI) 是指当腹压增加,如咳嗽或打喷嚏时,尿液会泄漏。我们通过倾向评分(PS)分析回顾性比较了无张力阴道吊带 (TVT) 和非消融阴道铒:YAG 激光治疗 (VEL) 在 SUI 女性中的疗效。目前还没有研究调查使用聚丙烯 TVT 和 VEL 进行尿道吊带手术治疗 SUI 的 PS 分析。选择了在多个机构接受 SUI 治疗并登记的 35-50 岁患者的数据。纳入了在 1 小时垫试验中有 1 年病历覆盖、完成国际尿失禁咨询问卷-简短表 (ICIQ-SF) 和膀胱过度活动症症状评分 (OABSS) 的患者。我们分别分析了 TVT、VEL 和对照组中的 102、113 和 112 例患者。与对照组相比,TVT 和 VEL 组在 1 小时垫试验和 ICIQ-SF 方面均有显著改善。在 PS 分析中,TVT 和 VEL 组在 1 小时垫试验和 ICIQ-SF 方面也有类似的改善。至于 OABSS,VEL 组的改善明显大于 TVT 组。在 1 小时垫试验的比值比分析中,TVT 和 VEL 组在任何参数上均无差异。VEL 可被视为治疗 SUI 的 TVT 的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d32/8803680/7238c13b7a9e/10103_2021_3317_Fig1_HTML.jpg

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