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改良腹腔镜Burch手术采用尿道两侧单针缝合治疗压力性尿失禁的疗效

The Efficacy of Modified Laparoscopic Burch Procedure Using a Single Stitch on Each Side of the Urethra for the Treatment of Stress Urinary Incontinence.

作者信息

Pirtea Marilena, Pirtea Laurențiu, Brasoveanu Simona, Balulescu Ligia, Olaru Flavius, Erdelean Dragos, Secosan Cristina, Navolan Dan

机构信息

Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.

出版信息

Medicina (Kaunas). 2025 Feb 28;61(3):436. doi: 10.3390/medicina61030436.

Abstract

: This study aimed to evaluate the efficacy and safety of modified laparoscopic Burch intervention over a 24-month follow-up period. : We performed a retrospective cohort evaluation including all eligible patients, 83 patients, who underwent modified laparoscopic Burch colposuspension for stress urinary incontinence (SUI). Primary outcomes included the presence or absence of SUI on follow-up and the success of index surgery based on responses to validated questionnaires of patient-reported outcomes. : Patient-reported outcomes indicated a progressive improvement in perceived well-being over time. At the 6-month follow-up, 50.6% of participants reported their condition as "greatly improved", increasing cumulatively to 66.7% by 24 months. The severity of urinary incontinence symptoms was markedly reduced following the intervention. The incidence of severe incontinence was notably low, with only 4.8% of patients affected at 6 months, remaining consistent at 5.1% at 24 months. This finding aligns with a high procedural success rate, as the vast majority of patients (≥94.9%) reported no severe symptoms across all follow-up intervals. Dryness, defined as the absence of urinary leakage, demonstrated an upward trend over time. At 6 months, 45.8% of patients reported complete dryness, with this figure rising to 55.1% at 12 months and 62.8% at 24 months. The Urogenital Distress Inventory-6 (UDI-6) served as a critical metric for evaluating the subjective burden of urinary symptoms. Across all follow-up intervals, over 97% of patients achieved scores below the clinically significant threshold (<33), indicating substantial symptom relief and enhanced quality of life. : The modified laparoscopic Burch colposuspension demonstrated consistent efficacy, with significant improvements in urinary continence, symptom severity, and quality of life over the 24-month follow-up period.

摘要

本研究旨在评估改良腹腔镜Burch手术在24个月随访期内的疗效和安全性。我们进行了一项回顾性队列评估,纳入了所有符合条件的83例因压力性尿失禁(SUI)接受改良腹腔镜Burch阴道悬吊术的患者。主要结局包括随访时SUI的有无以及基于患者报告结局的有效问卷回复评估的初次手术成功率。患者报告结局显示,随着时间推移,患者的幸福感逐渐改善。在6个月随访时,50.6%的参与者报告其状况“大幅改善”,到24个月时累计增至66.7%。干预后尿失禁症状的严重程度明显降低。严重尿失禁的发生率极低,6个月时仅有4.8%的患者受影响,24个月时保持在5.1%。这一发现与高手术成功率相符,因为绝大多数患者(≥94.9%)在所有随访期间均未报告有严重症状。定义为无尿液泄漏的干爽情况随时间呈上升趋势。6个月时,45.8%的患者报告完全干爽,这一数字在12个月时升至55.1%,在24个月时升至62.8%。泌尿生殖系统困扰量表-6(UDI-6)是评估尿路症状主观负担的关键指标。在所有随访期间,超过97%的患者得分低于临床显著阈值(<33),表明症状得到大幅缓解,生活质量得到提高。改良腹腔镜Burch阴道悬吊术显示出持续疗效,在24个月随访期内,尿失禁、症状严重程度和生活质量均有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7e4/11943953/2d1a2f2d076a/medicina-61-00436-g001.jpg

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