比較婦女應力性尿失禁使用不同路徑吊帶手術之長期手術效果

吳怡萱¹、江元宏²、陳聖復²、郭漢崇²

¹高雄市立小港醫院 泌尿科; ²花蓮慈濟醫院 泌尿部

Surgical Outcomes of Different Suburethral Sling Procedures for Female Stress Urinary Incontinence

Yi-Hsuan Wu¹, Yuan-Hong Jiang², Sheng-Fu Chen², Hann-Chorng Kuo²

¹Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;

²Department of Urology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan

Abstract

Purpose: Stress urinary incontinence (SUI) annoyed women worldwide and surgery remain importance for those who failed to observative managements.

Methods: We retrospectively reviewed medical records of 533 female patients with mixed urinary incontinence and predominant SUI in a medical center. Patients were divided into four groups: pubovaginal sling (PVS) alone, transobturator suburethral sling (TOT) alone, PVS with colporrhaphy, and TOT with colporrhaphy. The primary outcome was the long-term cumulative success rate in different groups and a successful outcome defined as dry or less than one pad usage per day. The secondary outcomes were subjective postoperative lower urinary tract symptoms and various perioperative complications.

Results: The long-term cumulative success rate of PVS group with or without colporrhaphy are significantly higher than those in TOT group with or without colporrhaphy (p< 0.001). The group of PVS with concurrent colporrhaphy obtained highest success rate, followed by the PVS alone, TOT with colporrhaphy and TOT alone (p=0.003). Furthermore, highest rate of persistent overactive bladder was noted in TOT alone group (p< 0.001).  

Conclusion: This study suggest PVS is superior to TOT in terms of incontinent symptom control and long-term success rate. Concurrent colporrhaphy may be also helpful for anti-incontinent effect.