Verneker Ruchika A, Mishra Vineet, Tutwala Nimish, Lamba Sunita
Department of Obstetrics and Gynaecology, Grant Medical College, Mumbai, Maharashtra, India.
Institute of Kidney Disease and Research Centre, Ahmedabad, Gujarat, India.
J Midlife Health. 2022 Apr-Jun;13(2):152-156. doi: 10.4103/jmh.jmh_185_21. Epub 2022 Sep 16.
Stress urinary incontinence (SUI) could be due to urethral hypermobility due to the weakening of the pelvic floor muscles which support the urethra and bladder or the intrinsic sphincter deficiency. The mid-urethral tape acts as an anchored pubo-urethral neo-ligament thus increasing the level of mid-urethral support. The purpose of this study is to evaluate the safety and efficacy of transobturator tape (TOT) for SUI at 5 years of follow-up.
This was a retrospective observational single-arm study of 40 patients. Ten patients were lost to follow-up; hence, only 30 patients were included in the study. Patients who underwent TOT from 2010 to 2012 were followed up till December 2017. Patients were evaluated for early and late postoperative complications and efficacy of the tape at 5 years.
The mean age of the patients with SUI was 48.07 (standard deviation ± 9.38). About 76.66% ( = 23) of patients had only pure stress incontinence, whereas 23.3% of patients ( = 7) had mixed urinary incontinence (MUI). The cure rate in our study was 93.33% at 5 years. Out of the seven patients with MUI, urge incontinence was cured in 71.42% ( = 5). urgency was observed in 6.6% ( = 2). No major complications such as bladder and bowel perforation, vascular hemorrhage, or mesh erosion were seen. Patient satisfaction was graded as excellent in 46.66% ( = 14), good in 30% ( = 9), and poor in 23% ( = 7).
TOT for stress incontinence has a high cure rate and very good efficacy at 5 years. No major complications are seen when the procedure is performed by expert hands.
压力性尿失禁(SUI)可能是由于支撑尿道和膀胱的盆底肌肉减弱导致尿道活动过度,或由于内在括约肌功能不全。中段尿道吊带起到固定的耻骨 - 尿道新韧带的作用,从而提高中段尿道的支撑水平。本研究的目的是评估经闭孔尿道中段吊带术(TOT)治疗压力性尿失禁5年随访期的安全性和有效性。
这是一项对40例患者的回顾性观察单臂研究。10例患者失访;因此,本研究仅纳入30例患者。对2010年至2012年接受TOT手术的患者随访至2017年12月。评估患者术后早期和晚期并发症以及吊带在5年时的疗效。
压力性尿失禁患者的平均年龄为48.07(标准差±9.38)。约76.66%(n = 23)的患者仅患有单纯性压力性尿失禁,而23.3%的患者(n = 7)患有混合性尿失禁(MUI)。本研究中5年时的治愈率为93.33%。在7例MUI患者中,急迫性尿失禁的治愈率为71.42%(n = 5)。有6.6%(n = 2)的患者出现尿急。未观察到膀胱和肠道穿孔、血管出血或网片侵蚀等严重并发症。患者满意度评为优秀的占46.66%(n = 14),良好的占30%(n = 9),差的占23%(n = 7)。
TOT治疗压力性尿失禁在5年时治愈率高且疗效良好。由专业人员进行该手术时未观察到严重并发症。