Sequential combined approach in patients with mixed urinary incontinence: surgery followed by posterior tibial nerve stimulation.

IF 17.7 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-02-01 Epub Date: 2022-07-04 DOI:10.23736/S2724-606X.22.05106-5

Valerio Carletti, Veronica Yacoub, Debora Grilli, Claudia Morgani, Pier L Palazzetti, Marzio A Zullo, Paolo Luffarelli, Herbert C Valensise, Francesco Maneschi, Vincenzo Spina, Michele C Schiavi

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Abstract

Background: The aim of the study was to demonstrate the efficacy of sequential combined treatment with transobturator tape (TOT) followed by posterior tibial nerve stimulation (PTNS) in patients with mixed urinary incontinence (MUI); quality of life and patients' satisfaction was also assessed.

Methods: Retrospective analysis on women affected by MUI with prevalent Stress Urinary Incontinence (SUI) component. Women, divided in 2 groups, underwent different treatments, TOT vs. TOT+PTNS. Population was assessed by medical history, previous pelvic surgery, clinical exam, urodynamic exams, pelvic ultrasound examination, and questionnaires (The International Consultation on Incontinence Questionnaire Short Form, Overactive Bladder Questionnaire, Health Related Quality of Life) comparing them before and after 12 weeks after treatment.

Results: One hundred twelve women were enrolled in the study. The mean age was 57.96±7.34 in the first group (N.=60) and 58.29±6.14 in the second group (N.=52). Peak flow (mL/s) statistically improved after treatment, 22.23±4.29 (TOT) vs. 24.81±5.8 (TOT+PTNS). First voiding desire (mL) improved significantly between the two groups 108.72±19.24 vs. 142.43±19.98. Maximum cystometric capacity (mL) in the TOT group at 12-weeks was 328.76±82.44 vs. TOT+PTNS group of 396.26±91.21. Detrusor pressure at peak flow(cmH2O) showed a greater improvement in TOT+PTNS than TOT alone 14.45±6.10 vs. 11.89±54.49. At 12-week, urinary diary and quality of life improved in terms of urgent urination events, mean number of voids, urge symptoms and nocturia events. The Patient Impression of Global Improvement (PGI-I) after 3 months was better in combined group.

Conclusions: Combined and sequential TOT+PTNS is more effective compared to TOT alone in MUI patients with prevalent SUI component.

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混合型尿失禁患者的序贯联合治疗法：手术后进行胫后神经刺激。

目的：该研究旨在证明对混合性尿失禁（MUI）患者进行经尿道绑带（TOT）和胫骨后神经刺激（PTNS）联合治疗的疗效，并对患者的生活质量和满意度进行评估：方法：对患有混合性尿失禁（MUI）并伴有压力性尿失禁（SUI）的妇女进行回顾性分析。妇女分为两组，接受不同的治疗：TOT vs TOT+PTNS。研究人员通过病史、既往盆腔手术、临床检查、尿动力学检查、盆腔超声波检查和问卷调查（尿失禁国际咨询问卷简表、膀胱过度活动症问卷、与健康相关的生活质量）对患者进行评估，并在治疗前和治疗后 12 周进行比较：112 名妇女参加了研究。第一组（60 人）的平均年龄为（57.96±7.34）岁，第二组（52 人）的平均年龄为（58.29±6.14）岁。治疗后峰值流量（ml/s）有统计学改善，22.23±4.29（TOT） vs 24.81±5.8（TOT+PTNS）。两组患者的首次排尿欲望（毫升）均有明显改善（108.72±19.24 vs 142.43±19.98）。12 周时，TOT 组的最大膀胱容量（毫升）为（328.76±82.44），而 TOT+PTNS 组为（396.26±91.21）。TOT+PTNS组的峰值尿流时的逼尿肌压力（cmH2O）比单纯TOT组有更大改善（14.45±6.10 vs 11.89±54.49）。12 周时，排尿日记和生活质量在急迫排尿事件、平均排尿次数、急迫症状和夜尿事件方面均有所改善。3个月后的患者总体改善印象（PGI-I）在联合组中更好：结论：与单独使用 TOT 相比，联合和连续使用 TOT+PTNS 对有普遍 SUI 成分的 MUI 患者更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.