Costa Clarissa, Barba Marta, De Vicari Desirèe, Cola Alice, Frigerio Matteo
Department of Gynecology and Obstetrics, University of Milano-Bicocca, 20126 Monza, Italy.
Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy.
Healthcare (Basel). 2025 Jun 25;13(13):1517. doi: 10.3390/healthcare13131517.
Stress urinary incontinence (SUI) is a common condition that can significantly impair a woman's quality of life. While initial management includes conservative treatments, surgical options are recommended in refractory cases. Suburethral slings are currently one of the most widely recommended surgical treatments due to their high long-term efficacy. However, complications such as postoperative urinary retention can occur and may lead to chronic voiding dysfunction when not promptly diagnosed and managed.
BACKGROUND/OBJECTIVES: The aim of this study was to evaluate the long-term voiding function in women undergoing delayed sling removal or incision for neglected chronic voiding dysfunction.
This retrospective study examined women with chronic voiding dysfunction occurring at least one year after suburethral sling placement for SUI. Preoperative evaluation included comprehensive history, physical examination, urethral ultrasound, uroflowmetry, and urodynamic studies. Surgical interventions consisted of partial or complete sling removal or sling incision (unilateral or bilateral). Postoperative follow-up was conducted at one month and then at 12 months, including clinical examination, ultrasound, and symptom assessment.
Sixteen patients were included in the study, all of whom presented with urodynamic confirmation of voiding dysfunction. Following surgical intervention, a significant improvement was observed in voiding symptoms and overall symptoms ( < 0.01). Notably, only one patient experienced persistent voiding difficulties, although complete symptom remission was achieved following sacral neuromodulation.
Sling removal or incision has proven to be an effective approach in resolving the majority of cases of neglected chronic voiding dysfunction. These findings suggest that, when appropriately performed, surgical intervention can substantially alleviate symptoms and improve patient well-being, providing an effective therapeutic option for what is often a debilitating condition.
压力性尿失禁（SUI）是一种常见病症，会严重损害女性的生活质量。虽然初始治疗包括保守治疗，但难治性病例建议采用手术治疗。由于长期疗效高，尿道下吊带目前是最广泛推荐的手术治疗方法之一。然而，可能会出现术后尿潴留等并发症，若不及时诊断和处理，可能会导致慢性排尿功能障碍。
背景/目的：本研究的目的是评估因慢性排尿功能障碍被忽视而接受延迟吊带拆除或切开的女性的长期排尿功能。
这项回顾性研究检查了因压力性尿失禁接受尿道下吊带置入术后至少一年出现慢性排尿功能障碍的女性。术前评估包括全面病史、体格检查、尿道超声、尿流率测定和尿动力学研究。手术干预包括部分或完全吊带拆除或吊带切开（单侧或双侧）。术后随访在1个月时进行，然后在12个月时进行，包括临床检查丶超声和症状评估。
16名患者纳入研究，所有患者均经尿动力学证实存在排尿功能障碍。手术干预后，排尿症状和总体症状有显著改善（<0.01）。值得注意的是，只有一名患者持续存在排尿困难，尽管在骶神经调节后症状完全缓解。
吊带拆除或切开已被证明是解决大多数被忽视的慢性排尿功能障碍病例的有效方法。这些发现表明，手术干预如果实施得当，可大幅缓解症状并改善患者健康状况，为这种通常使人衰弱的病症提供有效的治疗选择。
