Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2023 Mar;282:128-132. doi: 10.1016/j.ejogrb.2023.01.024. Epub 2023 Jan 23.
To investigate the role of preoperative maximal urethral closure pressure (MUCP) in predicting postoperative outcomes of trans-obturator tape (TOT) operation.
82 patients who underwent TOT surgery due to urodynamically proven stress urinary incontinence were retrospectively analyzed. Preoperative and 6th month postoperative results of cough stress tests (CST), Turkish validated Incontinence Impact Questionnaire-7 (IIQ-7) and Urogenital Distress Inventory-6 (UDI-6) quality of life (QOL) questionnaires were recorded. Patients who had negative CST and more than 50% improvement in the QOL questionnaires in the postoperative evaluation were classified as cured.
14 (17.1 %) patients had MUCP ≤ 20 cmH2O, 68 (83 %) patients had MUCP > 20 cmH2O. The postoperative IIQ-7 and UDI-6 QOL scores were significantly improved compared to preoperative values in both MUCP ≤ 20 cmH2O and MUCP > 20 cmH2O groups. However, cure rate was lower in the MUCP ≤ 20 cmH2O group than in MUCP > 20 cmH2O group (35.7 % vs 83.8 %, respectively). Preoperative MUCP measurement and urethral mobility assessment were found to be independent factors associated with surgical outcome. A preoperative MUCP ≥ 28.5 cmH2O could predict surgical success after TOT with 92.6 % sensitivity and 85.7 % specificity.
TOT is a reliable method that has a high efficacy in the surgical treatment of stress urinary incontinence in short-term. Patients with low MUCP can also benefit from TOT. However, the success rate of TOT surgery decreases in the presence of low MUCP and absence of hypermobile urethra.
探讨术前最大尿道闭合压（MUCP）在预测经闭孔吊带（TOT）手术术后结果中的作用。
回顾性分析 82 例因尿动力学证实压力性尿失禁而行 TOT 手术的患者。记录咳嗽应激试验（CST）、土耳其验证的尿失禁影响问卷-7（IIQ-7）和泌尿生殖窘迫问卷-6（UDI-6）生活质量（QOL）问卷的术前和术后 6 个月结果。术后评估中 CST 为阴性且 QOL 问卷改善超过 50%的患者被归类为治愈。
14 例（17.1%）患者 MUCP≤20cmH2O，68 例（83%）患者 MUCP＞20cmH2O。与术前相比，MUCP≤20cmH2O 和 MUCP＞20cmH2O 组患者术后 IIQ-7 和 UDI-6 QOL 评分均显著改善。然而，MUCP≤20cmH2O 组的治愈率低于 MUCP＞20cmH2O 组（分别为 35.7%和 83.8%）。术前 MUCP 测量和尿道活动度评估被发现是与手术结果相关的独立因素。术前 MUCP≥28.5cmH2O 可预测 TOT 术后成功率，其敏感性为 92.6%，特异性为 85.7%。
TOT 是一种可靠的方法，在短期治疗压力性尿失禁方面具有较高的疗效。低 MUCP 的患者也可以从 TOT 中受益。然而，在 MUCP 较低且尿道活动度不足的情况下，TOT 手术的成功率会降低。
