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经单切口微型吊带和经闭孔吊带治疗压力性尿失禁:5 年比较。

Single-incision mini-sling and trans-obturator sling for stress urinary incontinence: A 5-year comparison.

机构信息

Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy.

Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2022 Mar;270:90-94. doi: 10.1016/j.ejogrb.2022.01.005. Epub 2022 Jan 10.

Abstract

OBJECTIVE

The aim of our study was to compare objective and subjective outcomes in women with stress urinary incontinence (SUI) submitted to either trans-obturator sling (TVT-ABBREVO®) or single incision mini-sling (SIMS-ALTIS®) at 5-year follow up.

STUDY DESIGN

A monocentric, retrospective study including women with isolated SUI and with concomitant proved urodynamic stress incontinence (USI), treated with an TVT-ABBREVO® or SIMS-ALTIS®. At 60-month follow up each woman was assessed subjectively, with two validated questionnaires (UDI-6 and ICQI-SF), and objectively with a cough stress test. Adverse events were collected.

RESULTS

Forty-two patients were evaluated in the ABBREVO® group and 58 in the ALTIS® group. No significant difference was found in subjective (88.1% vs 89.7%, p = 0.806) and objective (81.0% vs 86.2%, p = 0.479) cure rates between the two groups. Subjectively, improvement in urinary distress after surgery resulted statistically significant in both groups compared to baseline (p < 0.001). Long-term post-operative complications rate (i.e. de novo OAB and sling exposure) was similar in the two groups. They were, in fact, mainly classified as Dindo II grade and conservatively managed (i.e. antimuscarinics or β agonists for de novo OAB).

CONCLUSION

This comparative study did not reveal significant difference between single-incision (ALTIS®) and trans-obturator (TVT-ABBREVO®) slings in terms of efficacy and morbidity at 5-year follow up.

摘要

目的

本研究旨在比较经阴道闭孔吊带(TVT-ABBREVO®)和单切口迷你吊带(SIMS-ALTIS®)治疗女性压力性尿失禁(SUI)患者在 5 年随访时的客观和主观结果。

研究设计

一项单中心回顾性研究,纳入了单纯性 SUI 和伴有经证实的尿动力学压力性尿失禁(USI)的女性患者,她们接受了 TVT-ABBREVO®或 SIMS-ALTIS®治疗。在 60 个月的随访时,每位患者都接受了主观评估,使用了两种经过验证的问卷(UDI-6 和 ICQI-SF),以及客观评估,包括咳嗽压力测试。收集了不良事件。

结果

在 ABBREVO®组中评估了 42 例患者,在 ALTIS®组中评估了 58 例患者。两组患者在主观(88.1% vs 89.7%,p=0.806)和客观(81.0% vs 86.2%,p=0.479)治愈率方面无显著差异。与基线相比,两组患者术后尿困扰均有统计学显著改善(p<0.001)。两组患者的长期术后并发症(即新发 OAB 和吊带暴露)发生率相似。事实上,这些并发症主要被归类为 Dindo II 级,并进行了保守治疗(即新发性 OAB 用抗毒蕈碱药物或β激动剂治疗)。

结论

本比较研究未发现单切口(ALTIS®)和经阴道闭孔吊带(TVT-ABBREVO®)在 5 年随访时的疗效和发病率方面存在显著差异。

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