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奥菲拉迷你吊带植入术后排尿模式的初步报告:从压力-流率研究中学到了什么?

Preliminary report of post-Ophira mini sling implantation voiding pattern: What to learn from pressure-flow studies?

作者信息

Gon Lucas Mira, Andrade Danilo Leite, Palma Paulo, Reis Leonardo O, Riccetto Cássio Luis Zanettini

机构信息

Division of Female Urology, University of Campinas (UNICAMP), Campinas, Brazil.

UroScience, University of Campinas (UNICAMP) and Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, Brazil.

出版信息

Curr Urol. 2021 Sep;15(3):181-184. doi: 10.1097/CU9.0000000000000026. Epub 2021 May 20.

Abstract

BACKGROUND

The study is amined to correlate the voiding pattern after successful mini sling Ophira implantation with postoperative symptoms and satisfaction, in addition to identifying obstructions.

MATERIALS AND METHODS

From 2012 to 2015 in a single institution, all consecutive patients who had stress urinary incontinence treated by using the mini sling Ophira had a pre- and 12 months postoperative urodynamic test. The (ICIQ-UI-SF) and the (ICIQ-OAB) translated into Portuguese, were given. Patients were objectively considered cured when presenting no urinary incontinence at the Valsalva test and subjectively cured when the ICIQ-UI-SF was zero.

RESULTS

Questionnaire scores were obtained from 29 patients and urodynamic data from 20 patients. Mini sling Ophira implantation resulted in a significant improvement of urinary symptoms evidenced by a significant mean reduction in ICIQ-UI-SF from 16 to 5 ( < 0.0001) and ICIQ-OAB from 8 to 4 ( = 0.0001). The subjective and objective cure rates were 55% and 45%, respectively. The urodynamic changes were not related to success even when adjusted for age, hormonal status, or anterior pelvic organ prolapse. The mean maximum flow decreased to 4.9 mL/s (95% CI: 0.62-10.8;  = 0.035), and the mean detrusor pressure at maximum flow increased to 11.4 cmHO (95% CI: 4-18;  = 0.0078).

CONCLUSIONS

Mini sling Ophira implantation decreased maximum urinary flow and increased the detrusor pressure at the maximum urinary flow and these urodynamic changes were not related to success.

摘要

背景

本研究旨在将成功植入小型Ophira吊带后的排尿模式与术后症状及满意度相关联,此外还需识别梗阻情况。

材料与方法

2012年至2015年在一家机构中,所有连续接受小型Ophira吊带治疗压力性尿失禁的患者均进行了术前及术后12个月的尿动力学检查。发放了翻译成葡萄牙语的国际尿失禁咨询问卷简表(ICIQ-UI-SF)和国际膀胱过度活动症咨询问卷(ICIQ-OAB)。在Valsalva试验中无尿失禁时客观上视为治愈,当ICIQ-UI-SF为零时主观上视为治愈。

结果

获取了29例患者的问卷评分及20例患者的尿动力学数据。小型Ophira吊带植入术使尿路症状得到显著改善,ICIQ-UI-SF平均显著降低,从16降至5(P<0.0001),ICIQ-OAB从8降至4(P=0.0001)。主观治愈率和客观治愈率分别为55%和45%。即使在对年龄、激素状态或盆腔前器官脱垂进行校正后,尿动力学变化与手术成功与否无关。平均最大尿流率降至4.9mL/s(95%CI:0.62 - 10.8;P=0.035),最大尿流率时的平均逼尿肌压力升至11.4cmH₂O(95%CI:4 - 18;P=0.0078)。

结论

小型Ophira吊带植入术降低了最大尿流率,增加了最大尿流率时的逼尿肌压力,且这些尿动力学变化与手术成功与否无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7356/8451316/9f2892df5584/curr-urol-15-181-g001.jpg

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