Trabzon Faculty of Medicine, Department of Obstetrics and Gynecology, University of Health Sciences, Trabzon, Turkey.
Fatih Sultan Mehmet Training and Research Hospital, Department of Urology, University of Health Sciences, Istanbul, Turkey.
Int Urogynecol J. 2023 Jul;34(7):1429-1436. doi: 10.1007/s00192-022-05381-5. Epub 2022 Oct 10.
Stress urinary incontinence (SUI) is the most common subtype of urinary incontinence, which causes many social, psychological, and economic problems. Mid-urethral sling (MUS) surgery is popular worldwide for the treatment of SUI. We aimed to define a new modified mid-urethral sling technique (mMUS) in SUI treatment and to compare it with transobturator tape (TOT) surgery in terms of safety and efficiency.
A prospective, randomized study was planned with 126 women suffering from SUI. The patients were randomly divided into two groups, TOT and mMUS. In mMUS, the obturator membrane was not perforated. The objective and subjective symptoms, pain, quality-of-life measures, and side effect profiles were assessed in a 3-year follow-up. The visual analogue scale (VAS) was used for postoperative pain assessment. The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Patient Global Impression of Improvement (PGI-I) were used for cure assessment scales.
In total, 96 patients completed 3-year follow-up (TOT, n = 49 and mMUS, n = 47). There was no statistical difference between the procedures in terms of cure rates (87.75% and 87.23%, respectively; p = 0.614). Mean VAS scores at 8 and 24 h postoperatively were significantly higher in the TOT group (p < 0.05). There was no significant difference between the groups in VAS scores after 24 h. There was no significant difference between groups in terms of pad test results, ICIQ, or PGI scores at baseline and 36 months after surgery.
We showed that the mMUS procedure was as safe and effective as TOT, with less postoperative groin pain and complications.
压力性尿失禁（SUI）是最常见的尿失禁类型，会导致许多社会、心理和经济问题。全球范围内，尿道中段悬吊带（MUS）手术是治疗 SUI 的常用方法。我们旨在定义一种新的改良尿道中段悬吊带技术（mMUS）用于治疗 SUI，并比较其与经闭孔吊带（TOT）手术在安全性和有效性方面的差异。
我们计划进行一项前瞻性、随机研究，共纳入 126 例 SUI 患者。患者被随机分为 TOT 和 mMUS 两组。在 mMUS 中，闭孔膜未穿孔。在 3 年的随访中，评估患者的客观和主观症状、疼痛、生活质量指标和副作用情况。术后疼痛评估采用视觉模拟评分（VAS）。采用国际尿失禁咨询委员会女性下尿路症状问卷（ICIQ-FLUTS）和患者整体改善印象（PGI-I）评估治愈情况。
共有 96 例患者完成了 3 年随访（TOT 组，n=49；mMUS 组，n=47）。在治愈率方面，两种手术方法之间无统计学差异（分别为 87.75%和 87.23%；p=0.614）。TOT 组术后 8 小时和 24 小时的平均 VAS 评分明显更高（p<0.05）。两组术后 24 小时的 VAS 评分无显著差异。两组间基线和术后 36 个月的垫试验结果、ICIQ 和 PGI 评分无显著差异。
我们表明，mMUS 手术与 TOT 一样安全有效，术后腹股沟疼痛和并发症较少。
