Altis®单切口吊带治疗尿压力性失禁患者的6年随访:一项前瞻性单中心研究

Dakota Viruega-Cuaresma, Sonia De-Miguel-Manso, E. García-García, Carmen E Badillo-Bercebal, Julio A Gobernado-Tejedor, Marta Pérez-Febles
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引用次数: 1

摘要

目的:单切口系带是最新一代的肱下系带,旨在将经闭带的发病率和主要并发症降至最低。从短期和中期来看,它们在成功和安全性方面的结果与经闭带和耻骨后带相似。然而,关于它们的长期效果的数据很少。我们的目的是在短期、中期和长期随访期间评估Altis®迷你吊带的安全性和有效性。方法:对67名接受Altis®手术的女性进行为期6年(2013-2019)的前瞻性观察研究。评估的主要变量为:完全尿失禁、客观治愈和主观治愈(满意度)。研究的次要变量是:并发症和术后每天使用的护垫数量。统计学:定量变量采用学生t检验或U-Mann-Whitney检验,分类变量采用卡方检验。结果:1 ~ 6年的客观治愈率分别为:96.77%、87.04%、87.50%、85.71%、76.92%和50%;1 ~ 6年的总尿失禁率分别为:85.48%、72.22%、64.88%、50%、46.15%和50%。满意度分别为:9分、8.2分、8.3分、7.7分、7.6分、6.5分(1 ~ 6年)。30例患者(44.78%)出现不同类型的并发症,最常见的是:“从头开始”尿急(20.90%)、再次出现压力性尿失禁(14.93%)和疼痛(5.97%)。结论:在6年的随访中,Altis®在短期和中期(1-5年)表现出较高的客观和主观失禁率。它是安全的,没有严重的并发症。我们发现压力性尿失禁的“新生”急症和复发率很高,特别是在第5年之后。
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Six-year follow-up in patients with urinary stress incontinence treated with Altis® single-incision sling: a prospective single-center study
Objetives: Single incision slings are the latest generation of suburethral bands that seek to minimize morbidity and major complications of transobturator bands. In short and medium term, their results in terms of success and safety are similar to transobturator and retropubic bands. Nevertheless, there is little data on their long-term outcomes. Our objective was to evaluate safety and efficacy of Altis® mini-sling during the short, medium and long-term follow-up. Methods: Prospective observational study in 67 women who underwent surgery with Altis® for a period of 6 years (2013-2019). The main variables evaluated were: total continence, objective cure and subjective cure (satisfaction). The secondary variables studied were: complications and number of pads used per day after surgery. Statistics: Student t-test or U-Mann-Whitney for quantitative variables, Chi-Square for categorical variables. Results: Objective cure rates were: 96.77%, 87.04%, 87.50%, 85.71%, 76.92% and 50% (from 1 to 6years), and total continence: 85.48%, 72.22%, 64.88%, 50%, 46.15% and 50% (from 1 to 6years). Degree of satisfaction was: 9, 8.2, 8.3, 7.7, 7.6 and 6.5 points (from 1 to 6years). 30 patients (44.78%) had some type of complication and the most common were: “de novo” urinary urgency (20.90%), recurrence of stress urinary incontinence (14.93%) and pain (5.97%). Conclusion: Altis® presents high rates of objective and subjective continence in short and medium-term (1-5years), during 6-year follow-up. It is safe and does not associate severe complications. We found a high percentage of “de novo” urgency and recurrence of stress urinary incontinence, especially after the fifth year.
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