Nian Songwen, Wang Xiaoqing, Lu Ye
Department of Obstetrics and Gynecology, Peking University First Hospital, No. 1 Xi'anmen Street, Beijing, 100034, China.
Int Urogynecol J. 2025 Mar;36(3):551-556. doi: 10.1007/s00192-024-05962-6. Epub 2024 Nov 4.
The objective was to evaluate the long-term subjective efficacy of the tension-free vaginal tape-obturator (TVT-O) technique in the treatment of female stress urinary incontinence (SUI).
A retrospective analysis was performed on 84 patients who underwent TVT-O surgery for SUI in a tertiary center between January 2007 and December 2013. All patients filled in the Urinary Incontinence Quality of Life Questionnaire (I-QOL), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12). Subjective efficacy, including surgical efficacy, clinical severity of SUI, improvement in quality of life (QoL), and sexual activity with regard to TVT-O were compared before and after surgery (≥ 10 years).
The average postoperative follow-up time was 12.6 ± 1.9 years, range, 10-16 years. The overall subjective effectiveness of the surgery was 94.0% (79 out of 84). The subjective clinical severity significantly improved more than 10 years after surgery compared with the preoperative value (p = 0.000). The median I-QOL score was 88.1 (84.1-92.0) preoperatively and 98.3 (94.3-99.7) postoperatively, and the long-term QoL of postoperative patients was significantly improved (p < 0.05). The median ICIQ-SF score was 10.5 (8-15) preoperatively, and 3 (0-5) postoperatively, and the ICIQ-SF score before and after surgery showed significant improvement in urinary incontinence symptoms (p < 0.05). No difference was observed in the PISQ-12 scores before and after surgery in the sexually active population.
The TVT-O technique still has good subjective efficacy in SUI more than 10 years after surgery and significantly improves the QoL of patients.
目的是评估无张力阴道吊带-闭孔术(TVT-O)治疗女性压力性尿失禁(SUI)的长期主观疗效。
对2007年1月至2013年12月在一家三级中心接受TVT-O手术治疗SUI的84例患者进行回顾性分析。所有患者均填写了尿失禁生活质量问卷(I-QOL)、国际尿失禁咨询问卷简表(ICIQ-SF)和盆腔器官脱垂/尿失禁性功能问卷简表(PISQ-12)。比较手术前后(≥10年)TVT-O的主观疗效,包括手术效果、SUI的临床严重程度、生活质量(QoL)改善情况以及性功能。
术后平均随访时间为12.6±1.9年,范围为10至16年。手术的总体主观有效率为94.0%(84例中的79例)。与术前相比,术后10多年主观临床严重程度显著改善(p = 0.000)。术前I-QOL评分中位数为88.1(84.1 - 92.0),术后为98.3(94.3 - 99.7),术后患者的长期QoL显著改善(p < 0.05)。术前ICIQ-SF评分中位数为10.5(8 - 15),术后为3(0 - 5),手术前后ICIQ-SF评分显示尿失禁症状有显著改善(p < 0.05)。在性活跃人群中,手术前后PISQ-12评分未观察到差异。
TVT-O技术在术后10多年治疗SUI方面仍具有良好的主观疗效,并显著改善患者的QoL。