Hillmeyer Alessia, Kennes Lieven N, Strauss Mila, Lube Katharina, Stickeler Elmar, Najjari Laila
Department of Obstetrics and Gynecology, University Hospital RWTH Aachen, 52074 Aachen, Germany.
Department of Econometrics and Statistics, University Stralsund, 18435 Stralsund, Germany.
J Clin Med. 2024 Dec 30;14(1):159. doi: 10.3390/jcm14010159.
: Transobturator tape (TOT) procedures are a widely used and effective treatment for stress urinary incontinence (SUI), but there is limited research on mesh-related complications and revision surgeries. This study aimed to evaluate the incidence of revision surgeries and mesh-related complications following TOT procedures and identify potential risk factors influencing these outcomes. : This retrospective study analyzed data from patients who underwent TOT procedures at the specialized incontinence center of University Hospital Aachen (UHA), Germany, between January 2010 and May 2023. Patients were divided into three groups: initial surgery without revision, initial surgery with revision, and external referrals requiring revision. Statistical analyses included multivariate logistic regression and predictive cross-validation to identify risk factors for revision and mesh-related complications. : Out of 265 TOT procedures performed, the revision rate was 8.7%, and the mesh-related complication rate was 2.6%. Mesh complications, including erosion and wound dehiscence, accounted for 30% of revisions, while 70% of revisions were caused by recurrent stress urinary incontinence (SUI). External referrals showed longer revision intervals compared to UHA patients (53 months vs. 5 months; = 0.003). Multivariate analysis identified rectoceles as a protective factor against revisions ( = 0.0414), while pre-existing conditions significantly increased revision risk ( = 0.0100). : The revision rate following TOT procedures was 8.7%, with mesh-related complications accounting for 2.6%. Pre-existing conditions significantly increased the risk of revision, while rectoceles were associated with improved outcomes. These findings emphasize the importance of identifying patient-specific risk factors to enhance the safety and success of TOT procedures.
经闭孔尿道中段无张力悬吊术（TOT）是压力性尿失禁（SUI）一种广泛应用且有效的治疗方法，但关于网片相关并发症和翻修手术的研究有限。本研究旨在评估TOT术后翻修手术的发生率和网片相关并发症，并确定影响这些结果的潜在风险因素。：这项回顾性研究分析了2010年1月至2023年5月在德国亚琛大学医院（UHA）专门的尿失禁中心接受TOT手术的患者数据。患者分为三组：初次手术未翻修、初次手术翻修和需要翻修的外部转诊。统计分析包括多因素逻辑回归和预测性交叉验证，以确定翻修和网片相关并发症的风险因素。：在265例TOT手术中，翻修率为8.7%，网片相关并发症发生率为2.6%。网片并发症，包括侵蚀和伤口裂开，占翻修的30%，而70%的翻修是由复发性压力性尿失禁（SUI）引起的。与UHA患者相比，外部转诊患者的翻修间隔更长（53个月对5个月；P = 0.003）。多因素分析确定直肠膨出是防止翻修的保护因素（P = 0.0414），而既往疾病显著增加翻修风险（P = 0.0100）。：TOT术后翻修率为8.7%，网片相关并发症占2.6%。既往疾病显著增加翻修风险，而直肠膨出与较好的结果相关。这些发现强调了识别患者特异性风险因素对提高TOT手术安全性和成功率的重要性。
