Li Yuqing, Wang Biao, Qiao Peng, Wang Wei, Guan Xing
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Aug 18;56(4):600-604. doi: 10.19723/j.issn.1671-167X.2024.04.009.
To investigate the effectiveness and clinical efficacy of tension-free vaginal tape (TVT) surgery in treating female recurrent stress urinary incontinence (rSUI).
A retrospective analysis was conducted on 24 patients who experienced recurrence of mid-urethral sling failure and were treated with TVT surgery at Beijing Chao-Yang Hospital from January 2016 to June 2020. Basic patient information was collected. The International Consultation on Incontinence questionnaire-short form (ICI-Q-SF) was used to record urinary incontinence symptom scores preoperatively, 1-year postoperatively, and more than three years postoperatively. The changes in various ICI-Q-SF scores and total scores were compared. Additionally, clinical symptom severity of urinary incontinence was recorded and compared preoperatively and more than three years postoperatively.
Among the 24 patients included in the follow-up, one patient was lost to follow-up due to death from a cerebrovascular accident one year postoperatively, leaving 23 patients with a follow-up period ranging from 3.9 to 7.3 years, with an ave-rage follow-up time of (5.2±1.1) years. Preoperatively, the median ICI-Q-SF total score was 20.0 (16.0, 21.0); at the 1-year follow-up, the median ICI-Q-SF total score was 5.0 (1.5, 7.8) ( < 0.001); at an average follow-up of five years, the median ICI-Q-SF total score was 6.0 (3.0, 9.0), still showing a statistically significant difference compared with preoperative scores ( < 0.001). The individual ICI-Q-SF scores were significantly lower at the 1-year and average five-year follow-ups compared with preoperative scores ( < 0.001). Regarding the severity of urinary incontinence, all the patients had moderate to severe urinary incontinence preoperatively; Five years postoperatively, 87.0% (20/23) of the patients had no or only mild urinary incontinence, and 13.0% (3/23) had recurrent moderate to severe urinary incontinence ( < 0.001).
TVT surgery is effective in treating female recurrent stress urinary incontinence, with an average 5-year cure and improvement rate of 87.0%.
探讨无张力阴道吊带术（TVT）治疗女性复发性压力性尿失禁（rSUI）的有效性及临床疗效。
对2016年1月至2020年6月在北京朝阳医院接受TVT手术治疗的24例中段尿道吊带术失败复发患者进行回顾性分析。收集患者基本信息。采用国际尿失禁咨询委员会简表（ICI-Q-SF）记录术前、术后1年及术后3年以上的尿失禁症状评分。比较各ICI-Q-SF评分及总分的变化。此外，记录并比较术前及术后3年以上尿失禁的临床症状严重程度。
纳入随访的24例患者中，1例患者术后1年因脑血管意外死亡失访，其余23例患者随访时间为3.9至7.3年，平均随访时间为（5.2±1.1）年。术前，ICI-Q-SF总分中位数为20.0（16.0，21.0）；术后1年随访时，ICI-Q-SF总分中位数为5.0（1.5，7.8）（P<0.001）；平均随访5年时，ICI-Q-SF总分中位数为6.0（3.0,9.0），与术前评分相比仍有统计学差异（P<0.001）。术后1年及平均5年随访时，各ICI-Q-SF单项评分均较术前显著降低（P<0.001）。尿失禁严重程度方面，术前所有患者均为中重度尿失禁；术后5年，87.0%（20/23）的患者无尿失禁或仅有轻度尿失禁，13.0%（3/23）的患者复发中重度尿失禁（P<0.001）。
TVT手术治疗女性复发性压力性尿失禁有效，平均5年治愈及改善率为87.0%。
