Lorenzo-Gómez María-Fernanda, Flores-Carvajal Javier-Antonio, Márquez-Sánchez Magaly-Teresa, Márquez-Sánchez Gerardo-Alfonso, Flores-Fraile Javier, Alves-Rodrigues Filipa-María, Miron-Canelo Jose-Antonio, Padilla-Fernández Bárbara Yolanda
Department of Surgery, University of Salamanca, 37007 Salamanca, Spain.
Group GRUMUR (Urology Multidisciplinary Research Group), IBSAL (Institute for Biomedical Research of Salamanca), 37007 Salamanca, Spain.
J Clin Med. 2024 Sep 26;13(19):5728. doi: 10.3390/jcm13195728.
Female stress urinary incontinence (SUI) surgical treatment has changed since its beginning. Selecting materials that promote constructive tissue remodelling helps to maintain continence after surgery and minimizes complications. To analyze the long-term urinary continence results in women who underwent SUI surgical correction using the transobturator mid-urethral sling KIM system (Knotless Incontinence Mesh) and analyze the complications associated with this SUI treatment. Prospective study of the first 1000 patients undergoing SUI surgery with the Contasure KIM sling between April 2007 and December 2018. Results and complications were recorded. Group A represented 94.2% of the sample and were the continent patients after surgery (GA = 942), while Group B accounted for incontinent patients after surgery (5.8%) (GB = 58). : The mean age at operation was 60 years. Eutocic deliveries ( = 0.0022), high blood pressure ( = 0.0190), anxiety ( = 0.0084), hemorrhoidectomies ( = 0.0016) and hysterectomies ( = 0.0002) were higher in GB. No differences between groups were found regarding body mass index (GA 26.50; GB 26.93) ( = 0.220649), food or drug allergies ( = 0.0.6547), dystocia ( = 0.2365), diabetes mellitus ( = 0.1715), pelvic surgery ( = 0.8842), other surgery ( = 0.8801) or concomitant treatments that would have an impact on bladder function. Correction of SUI was achieved in 94.2% of cases. Continence persisted over time in 97.98% of continent patients at 4-year follow-up and 90.90% of patients at last follow-up. Mesh caused erosion of the urethra in 0.3% of patients and extruded to the vagina in 0.42%. De novo urinary urgency (2.8%), significant chronic pain (3.6%) and urinary tract infections (3.0%) after surgery were lower than complications reported in reviewed publications. Pain was treated with medication, and all patients were pain-free at the one-year follow-up visit. : The mid-urethral transobturator sling KIM system has good initial and long-term results in patients with stress urinary incontinence, with a low recurrence rate and minimal complications.
女性压力性尿失禁(SUI)的外科治疗自开始以来已经发生了变化。选择能够促进建设性组织重塑的材料有助于术后维持控尿能力并将并发症降至最低。分析使用经闭孔尿道中段吊带KIM系统(无结失禁网片)进行SUI手术矫正的女性的长期尿失禁结果,并分析与这种SUI治疗相关的并发症。对2007年4月至2018年12月期间接受Contasure KIM吊带SUI手术的前1000例患者进行前瞻性研究。记录结果和并发症。A组占样本的94.2%,为术后控尿患者(GA = 942),而B组为术后尿失禁患者(5.8%)(GB = 58)。手术时的平均年龄为60岁。GB组中顺产(= 0.0022)、高血压(= 0.0190)、焦虑(= 0.0084)、痔切除术(= 0.0016)和子宫切除术(= 0.0002)的发生率更高。在体重指数(GA 26.50;GB 26.93)(= 0.220649)、食物或药物过敏(= 0.0.6547)、难产(= 0.2365)、糖尿病(= 0.1715)、盆腔手术(= 0.8842)、其他手术(= 0.8801)或会对膀胱功能产生影响的伴随治疗方面,两组之间未发现差异。94.2%的病例实现了SUI的矫正。在4年随访时,97.98%的控尿患者和最后随访时90.90%的患者持续保持控尿。网片在0.3%的患者中导致尿道侵蚀,在0.42%的患者中挤出至阴道。术后新发尿急(2.8%)、严重慢性疼痛(3.6%)和尿路感染(3.0%)低于已发表综述中的并发症报告。疼痛通过药物治疗,所有患者在一年随访时均无疼痛。经闭孔尿道中段吊带KIM系统在压力性尿失禁患者中具有良好的初始和长期效果,复发率低且并发症极少。