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阿根廷女性无张力阴道吊带手术的长期结果:20年后的首份报告

Long-Term Outcomes of Tension-Free Vaginal Tape Procedures in Argentine Women: Our First Report After 20 Years.

作者信息

Soderini Héctor Federico Eduardo, Anzoátegui Maria Paula Farías, Lidgett Nicolas, Vendramini Agustina, Ubertazzi Enrique Patricio

机构信息

Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Complejo Médico Churruca Visca, Buenos Aires, Argentina.

出版信息

Int Urogynecol J. 2025 Jan;36(1):93-99. doi: 10.1007/s00192-024-05972-4. Epub 2024 Nov 4.

Abstract

INTRODUCTION AND HYPOTHESIS

Transvaginal tape is currently a stress urinary incontinence (SUI) treatment with recommendation grade A in accordance with the 7th International Consultation on Incontinence. The main aim of the present study was to evaluate objective and subjective outcomes of tension-free vaginal tape (TVT) 20 years after our medical group started to use it. A second aim was to describe the voiding phase and the immediate, medium-term, and late complications of TVT procedures.

METHODS

This is a retrospective cohort study that included patients diagnosed with SUI who received TVT treatment in a tertiary care hospital in Argentina from 1999 to 2003. Objective outcomes were recorded in a medical visit by means of urogynecological examination, which included a cough stress test with a comfortably full bladder and uroflowmetry. Subjective outcomes were assessed using quality-of-life questionnaires and questions addressed to the patient, regarding whether the patient felt cured and would recommend surgery.

RESULTS

A total of 74 patients with an average follow-up of 18 years were evaluated. Most of the patients evaluated (96.8%) were objectively continent in the long term, 95.3% reported feeling cured, and 97.6% would recommend surgery. The complications were similar to those reported in the literature. No cases of voiding disorder were found in the long-term follow-up.

CONCLUSIONS

Tension-free vaginal tape is a minimally invasive, safe, and effective surgical technique, with a high objective and subjective cure rate, a low rate of complications related to the mesh or aging, and good results in long-term follow-up.

摘要

引言与假设

经阴道无张力尿道中段吊带术目前是一种治疗压力性尿失禁的方法,根据第七届国际尿失禁咨询会议,其推荐等级为A。本研究的主要目的是评估我们医疗团队开始使用无张力阴道吊带术(TVT)20年后的客观和主观结果。第二个目的是描述TVT手术的排尿阶段以及即刻、中期和晚期并发症。

方法

这是一项回顾性队列研究,纳入了1999年至2003年在阿根廷一家三级护理医院接受TVT治疗的压力性尿失禁患者。通过泌尿妇科检查记录客观结果,检查包括在膀胱适度充盈时进行咳嗽压力试验和尿流率测定。使用生活质量问卷并向患者提问来评估主观结果,问题涉及患者是否感觉治愈以及是否会推荐手术。

结果

共评估了74例患者,平均随访18年。大多数接受评估的患者(96.8%)长期客观上无尿失禁,95.3%的患者报告感觉治愈,97.6%的患者会推荐手术。并发症与文献报道的相似。长期随访中未发现排尿障碍病例。

结论

无张力阴道吊带术是一种微创、安全且有效的手术技术,客观和主观治愈率高,与网片或老化相关的并发症发生率低,长期随访效果良好。

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