Kaur Tarang Preet, Xinyi Kimberly Lim, Barnes Chloe, Attarbashi Shatha, Shahid Naweed
Obstetrics and Gynaecology, Glasgow Royal Infirmary/ NHS Greater Glasgow and Clyde, Glasgow, GBR.
Obstetrics and Gynaecology, Saint Mary's Hospital/ Manchester University NHS Foundation Trust, Manchester, GBR.
Cureus. 2025 May 9;17(5):e83815. doi: 10.7759/cureus.83815. eCollection 2025 May.
Stress urinary incontinence (SUI) significantly impairs quality of life. This retrospective audit aimed to evaluate surgical treatment patterns and outcomes for SUI at a district general hospital between 2018 and 2023 and to compare them with national benchmarks from the third British Society of Urogynaecology (BSUG) report in 2020-21. Data from 99 patients were collected from the BSUG database and hospital electronic records, following clinical audit department approval. The mean age of patients undergoing surgery was 50 years. In 2018, mid-urethral tape was the most commonly performed procedure (46.2%); however, following the UK-wide suspension of vaginal mesh procedures that year, there was a notable shift towards alternative surgeries. Bladder neck injections (BNIs), colposuspension (open and laparoscopic), and autologous fascial sling (AFS) procedures all increased in frequency, mirroring national trends. BNIs became the predominant procedure, accounting for 76.8% of cases, with over 80% performed on an outpatient basis. Reported cure rates, when compared to national figures, were AFS (100% vs. 94%), laparoscopic colposuspension (71.4% vs. 84%), BNIs (66% vs. 60%), and open colposuspension (33.3% vs. 81%). Bladder injuries occurred in 17.3% of colposuspension cases, significantly higher than the national average of 2.7%. Additionally, prolonged catheterisation (>10 days) was noted in 29% of colposuspension cases, compared to 7.1% nationally. These elevated complication rates may reflect the procedural learning curve, as laparoscopic colposuspension was only recently introduced at the center. The audit highlights evolving surgical trends and outcomes in the management of SUI following the national mesh pause, with a shift toward non-mesh alternatives. Further audits with long-term follow-up and larger sample sizes are recommended to assess the safety, efficacy, and patient-reported outcomes of these procedures.
压力性尿失禁（SUI）严重影响生活质量。这项回顾性审计旨在评估2018年至2023年间一家地区综合医院SUI的手术治疗模式及结果，并将其与英国泌尿妇科协会（BSUG）2020 - 2021年第三次报告中的全国基准进行比较。经临床审计部门批准后，从BSUG数据库和医院电子记录中收集了99例患者的数据。接受手术患者的平均年龄为50岁。2018年，尿道中段吊带术是最常施行的手术（46.2%）；然而，在当年全英国暂停阴道网片手术之后，手术明显转向了其他替代手术。膀胱颈注射（BNI）、阴道悬吊术（开放和腹腔镜）以及自体筋膜吊带（AFS）手术的施行频率均有所增加，这与全国趋势相符。BNI成为了主要手术方式，占病例的76.8%，其中超过80%是在门诊进行的。与全国数据相比，报告的治愈率分别为：AFS（100%对94%）、腹腔镜阴道悬吊术（71.4%对84%）、BNI（66%对60%）以及开放阴道悬吊术（33.3%对81%）。阴道悬吊术病例中有17.3%发生膀胱损伤，显著高于全国平均水平的2.7%。此外，29%的阴道悬吊术病例出现导尿时间延长（>10天），而全国水平为7.1%。这些较高的并发症发生率可能反映了手术学习曲线，因为腹腔镜阴道悬吊术是该中心最近才引入的。此次审计突出了全国网片暂停后SUI管理中不断变化的手术趋势和结果，手术转向了非网片替代方案。建议进行长期随访和更大样本量的进一步审计，以评估这些手术的安全性、疗效以及患者报告的结果。
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