Gao Qianqian, Lou Wenjia, Song Xiaochen, Guo Jianbin, Ye Yang, Zhang Yiwei, Dou Zhiyuan, Zhao Xiaoyue, Shi Honghui, Sun Zhijing, Chen Juan, Zhu Lan
Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Common Mechanism Research for Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China.
Heliyon. 2024 May 7;10(10):e30805. doi: 10.1016/j.heliyon.2024.e30805. eCollection 2024 May 30.
Colpocleisis is one of traditional surgical procedures for elderly and frail women with advanced pelvic organ prolapse. The occurrence of de novo urinary incontinence following colpocleisis was considered to impair the postoperative quality of life. The incidence of de novo urinary incontinence after colpocleisis has been reported to be ranging from 6.6 % to 27 %. There was an absence of prospective large-sample study to investigate the accurate incidence of de novo urinary incontinence following colpocleisis and the impact on the quality of life till now.
s The primary objective was to report the incidence of de novo urinary incontinence after colpocleisis. The second objectives were to evaluate the long-term quality of life in patients with de novo urinary incontinence, and to conduct detailed pre- and post-operative evaluations of lower urinary tract symptoms.
This prospective study included 253 patients with symptomatic pelvic organ prolapse who underwent colpocleisis between 2009 and 2021. De novo urinary incontinence was defined as the occurrence of urinary incontinence 3 months postoperatively. All patients were required to complete the Urinary Distress Inventory questionnaire and the Urinary Impact Questionnaire for the evaluation of patients' quality of life, and the Patient Global Impression of Improvement questionnaire for the evaluation of patients' satisfaction.
245 patients (245/253, 96·8 %) completed the 3-month follow-up, and were included in the final analysis. The incidence of de novo urinary incontinence was 5.4 % (10/185). There was no significant difference in the Urinary Distress Inventory -6 scores (22.50 vs. 10.30, = 0.276) or the subjective satisfaction rate (100 % vs. 98.9 %, = 0.250) between the patients with or without de novo urinary incontinence at the long-term follow-up. The incidence of voiding difficulty was significantly reduced after colpocleisis (27.8 % vs. 0.0 %, < 0.001). The patients' quality of life indicated by Urinary Distress Inventory-6 and Urinary Impact Questionnaire-7 scores were significantly improved postoperatively (26.27 vs. 13.39, and 19.13 vs. 6.05, < 0.05).
The incidence of de novo urinary incontinence after colpocleisis was very low. Patients' quality of life, and low urinary tract symptoms were significantly improved after colpocleisis.
阴道封闭术是治疗晚期盆腔器官脱垂的老年体弱女性的传统外科手术之一。阴道封闭术后新发尿失禁的发生被认为会损害术后生活质量。据报道，阴道封闭术后新发尿失禁的发生率在6.6%至27%之间。迄今为止，尚无前瞻性大样本研究来调查阴道封闭术后新发尿失禁的准确发生率及其对生活质量的影响。
主要目的是报告阴道封闭术后新发尿失禁的发生率。第二个目的是评估新发尿失禁患者的长期生活质量，并对下尿路症状进行详细的术前和术后评估。
这项前瞻性研究纳入了2009年至2021年间接受阴道封闭术的253例有症状的盆腔器官脱垂患者。新发尿失禁定义为术后3个月出现尿失禁。所有患者均需完成尿失禁困扰量表问卷和尿失禁影响问卷以评估患者的生活质量，以及患者总体改善印象问卷以评估患者的满意度。
245例患者（245/253，96.8%）完成了3个月的随访，并纳入最终分析。新发尿失禁的发生率为5.4%（10/185）。在长期随访中，有或无新发尿失禁的患者在尿失禁困扰量表-6评分（22.50对10.30，P = 0.276）或主观满意率（100%对98.9%，P = 0.250）方面无显著差异。阴道封闭术后排尿困难的发生率显著降低（27.8%对0.0%，P < 0.001）。尿失禁困扰量表-6和尿失禁影响问卷-7评分所显示的患者生活质量在术后显著改善（26.27对13.39，以及19.13对6.05，P < 0.05）。
阴道封闭术后新发尿失禁的发生率非常低。阴道封闭术后患者的生活质量和下尿路症状得到显著改善。
