Kuroda Kenji, Hamamoto Koetsu, Kawamura Kazuki, Masunaga Ayako, Kobayashi Hiroaki, Horiguchi Akio, Ito Keiichi
Department of Urology, National Defense Medical College, Tokorozawa, Japan.
Int Neurourol J. 2024 Sep;28(3):215-224. doi: 10.5213/inj.2448234.117. Epub 2024 Sep 30.
Stress urinary incontinence is a postoperative complication occurring in patients with pelvic organ prolapse (POP). Although the 1-hour pad test measures the degree of urinary incontinence qualitatively and quantitatively, some elderly women undergoing POP surgery do not have the daily activities of living to perform the pad test. Therefore, we examined whether the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) could be used as an alternative tool for pad tests.
We retrospectively evaluated 132 patients with POP. In our hospital, 57 patients were treated by laparoscopic sacrocolpopexy (LSC), whereas 75 were treated by transvaginal mesh surgery (TVM). We measured the changes in symptoms preand postoperatively using the ICIQ-SF and 1-hour pad weight testing, and investigated the correlation between the total plus component question scores of the ICIQ-SF and 1-hour pad weight.
The preoperative ICIQ total scores in all patients decreased significantly as the amount of leakage on the 1-hour pad weight decreased. The component question scores also decreased significantly with decreasing levels of 1-hour pad weight. The LSC and TVM groups had decreased ICIQ-SF total and component question scores as pad weight decreased. At 12 months postoperatively, the ICIQ total scores in all patients significantly declined as the amount of leakage on the 1-hour pad weight decreased. In the LSC group, the ICIQ-SF total and component question scores also decreased with decreased pad weight, but the differences were not always significant between ICIQ scores and pad weight. In the TVM group, the ICIQ-SF total and component question scores also significantly decreased as the pad weight decreased.
The ICIQ-SF could be an appropriate substitute for the 1-hour pad weight testing in predicting the severity of urinary incontinence. In the future, we hope to predict the level of urine leakage based on the ICIQ-SF score.
压力性尿失禁是盆腔器官脱垂（POP）患者术后出现的一种并发症。尽管1小时垫试验能定性和定量地测量尿失禁程度，但一些接受POP手术的老年女性没有进行垫试验所需的日常活动能力。因此，我们研究了国际尿失禁咨询问卷简表（ICIQ-SF）是否可作为垫试验的替代工具。
我们回顾性评估了132例POP患者。在我院，57例患者接受了腹腔镜骶骨阴道固定术（LSC），而75例接受了经阴道网片手术（TVM）。我们使用ICIQ-SF和1小时垫重试验测量了患者术前和术后症状的变化，并研究了ICIQ-SF总分及各分量表得分与1小时垫重之间的相关性。
所有患者术前ICIQ总分随着1小时垫重试验中漏尿量的减少而显著降低。各分量表得分也随着1小时垫重水平的降低而显著下降。随着垫重的降低，LSC组和TVM组的ICIQ-SF总分及各分量表得分均下降。术后12个月，所有患者的ICIQ总分随着1小时垫重试验中漏尿量的减少而显著下降。在LSC组，ICIQ-SF总分及各分量表得分也随着垫重的降低而下降，但ICIQ得分与垫重之间的差异并不总是显著。在TVM组，随着垫重的降低，ICIQ-SF总分及各分量表得分也显著下降。
ICIQ-SF在预测尿失禁严重程度方面可作为1小时垫重试验的合适替代方法。未来，我们希望根据ICIQ-SF评分来预测漏尿水平。
