经通气带与前阴道摄影术治疗压力性尿失禁的疗效比较

Z. Nazari, F. Yazdanpanah, M. Karimi-Zarchi, Negar Ghaffari, Fatemeh Mohajerfar
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引用次数: 1

摘要

摘要压力性尿失禁(Stress urinary incontinence, SUI)在女性中发病率高,并对其生活质量产生负面影响。手术是治疗这个问题最有效的方法。因此,本研究旨在比较经通气带(TOT)与前阴道造影(APR)在压力性尿失禁患者中的疗效。方法:我们设计了一项前瞻性队列研究。根据纳入和排除标准,我们将65例患者随机纳入本研究,其中TOT组33例,APR组32例。收集患者术前、术后2个月、6个月、18个月的资料,填写尿失禁生活质量问卷(ikol)。我们使用SPSS 18进行数据分析。结果:TOT组平均手术时间明显少于APR组(P<0.0001)。TOT组患者术后6、18个月的生活质量明显优于对照组(P<0.05)。TOT组术后2、6、18个月尿失禁患者数(P<0.01),术后18个月活动期间尿失禁患者数(P=0.031),术后6、18个月尿失禁严重程度(P<0.001)均显著低于对照组。两组术后并发症比较差异无统计学意义(P=0.78)。而TOT组有21例(63.6%)和APR组有9例(28.1%)有术后疼痛主诉(P=0.004)。平均住院时间差异无统计学意义(P=0.54)。最后,TOT组23例(63.9%)和APR组13例(36.1%)在最后一个月内出现尿失禁(OR:3.36, 95%, CL: 1,20-9.36, P=0.018)。TOT组25例(61%)和APR组16例(39%)患者的生活质量改善超过90% (OR: 3.12, 95% CL: 1.08 ~ 8.97, P=0.031)。结论:本研究结果表明TOT技术比APR技术更有效。该技术成功率高,患者满意度高,可显著提高患者的生活质量。
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The Comparison of the Treatment Outcomes of Transobturator Tape and Anterior Colporraphy in Stress Urinary Incontinence
Introduction: Stress urinary incontinence (SUI) in women had high prevalence and has a negative impact on their quality of life. Surgery is the most effective way to treat this problem. So, this study designed to compare the efficacy of transobturator tape (TOT) versus anterior colporraphy (APR) in stress incontinence patients. Methods: We designed a prospective cohort study. On base of inclusion and exclusion criteria, we had 65 patients (33 patients in TOT group, 32 patients in APR group) were randomly enrolled in this study. Patients data before surgery, 2 months, 6 months and 18 months after surgery were collected and asked them to complete incontinence quality of life questionnaires (IQOL). We used SPSS 18 for data analysis. Results: Mean surgery time in TOT group was significantly less than APR group (P<0.0001). Quality of life at 6 and 18 months after surgery was significantly better in TOT group (P<0.05). Number of incontinence patients at 2, 6 and 18 months after surgery (P<0.01), incontinence during activity at 18 months after surgery (P=0.031), severity of urinary incontinence at 6 months and 18 months after surgery (P<0.001) were significantly lower in TOT group. Complications after surgery was not different between 2 groups (P=0.78). However, 21 cases in TOT group (63.6%) and 9 cases in APR group (28.1%) complained of pain after surgery (P=0.004). The mean of hospitalization was not statistically significant difference (P=0.54). Finally, 23 patients in TOT group (63.9%) and 13 patients in APR group (36.1%) had urinary incontinence within one last month (OR:3.36, 95%, CL: 1,20-9.36, P=0.018). Furthermore, 25 patients in TOT group (61%) and 16 patients in APR group (39%) had more than 90% improvement in their quality of life (OR: 3.12, 95% CL: 1.08-8.97, P=0.031). Conclusion: The results of this study showed that the TOT techniques more efficient than the APR technique. This technique has more success rate, higher satisfaction of patients and can significantly improve patient's quality of life.
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