Perrouin-Verbe Marie-Aimee, Ochoa D-Carolina, Skews Rachel, Acharya Mez, Prouza Antonin, Hashim Hashim
Bristol Urological Institute Southmead Hospital Bristol UK.
Department of Trauma and Orthopaedic Surgery Southmead Hospital Bristol UK.
BJUI Compass. 2024 Mar 20;5(5):454-464. doi: 10.1002/bco2.317. eCollection 2024 May.
The objective of this study is to describe a standardised technique of full TOT removal with groin dissection and to report clinical improvement, satisfaction, safety and long-term functional, quality of life (QoL) and sexual QoL outcomes.
A retrospective review enrolling all women who had full TOT removal, in a tertiary referral centre from May 2017 to November 2020. Functional outcomes, satisfaction and QoL were assessed using a bespoke composite questionnaire (UDI-6, EQ-5D-5L and ICIQ-S) with additional questions on sexual QoL. Secondary outcomes were post-operative recurrent stress urinary incontinence (SUI) and complication rate according to the Clavien-Dindo classification.
Full TOT removal using a vaginal approach and bilateral groin/para-labial incisions was performed in 67 patients. Chronic pelvic pain was the main indication for mesh removal (51% of cases, = 34). QoL questionnaires were answered by 43 patients. The satisfaction rate was high 86% ( = 37), and 81% ( = 35) of the patients considered the surgery successful. Seventy per cent ( = 30) of patients returned to having a sexual life after surgery. Recurrent SUI was reported in 32% ( = 14) of cases. The complication rate was 10% (7/67), all of them Clavien-Dindo ≤2.
Despite a high rate of postoperative bothersome SUI, full TOT removal with bilateral groin dissection improves pain and QoL. It is associated with a high overall satisfaction rate and an acceptable rate of complications.
本研究的目的是描述一种采用腹股沟淋巴结清扫术完全取出经阴道无张力尿道中段吊带术(TOT)的标准化技术,并报告临床改善情况、满意度、安全性以及长期功能、生活质量(QoL)和性QoL结果。
对2017年5月至2020年11月在一家三级转诊中心接受完全取出TOT的所有女性进行回顾性研究。使用定制的综合问卷(UDI-6、EQ-5D-5L和ICIQ-S)评估功能结果、满意度和生活质量,并附加有关性QoL的问题。次要结果是根据Clavien-Dindo分类法得出的术后复发性压力性尿失禁(SUI)和并发症发生率。
67例患者采用阴道入路及双侧腹股沟/阴唇旁切口进行了完全TOT取出术。慢性盆腔疼痛是取出补片的主要指征(51%的病例,n = 34)。43例患者回答了生活质量问卷。满意度较高,为86%(n = 37),81%(n = 35)的患者认为手术成功。70%(n = 30)的患者术后恢复了性生活。32%(n = 14)的病例报告有复发性SUI。并发症发生率为10%(7/67),所有并发症的Clavien-Dindo分级均≤2。
尽管术后烦人的SUI发生率较高,但采用双侧腹股沟淋巴结清扫术完全取出TOT可改善疼痛和生活质量。它与较高的总体满意度和可接受的并发症发生率相关。