女性應力性尿失禁尿道下懸吊手術在不同的膀胱功能的成功率
翁慧鈴1、劉昕和2、郭漢崇1
1花蓮慈濟醫院 泌尿部； 2台中慈濟醫院 泌尿科
Long-term success rate of suburethral sling procedure in stress urinary incontinence patients with different bladder function
Hueih Ling Ong 1, Hshin-Ho Liu2, Hann-Chorng Kuo1
1Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien City, 2Department of Urology, Taichung Tzu Chi Hospital, Taichung, Taiwan
Purpose: To investigate the long-term success rate of suburethral sling in stress urinary incontinence (SUI) patients with different bladder function such as stable bladder, detrusor overactivity (DO) and detrusor underactivity (DU).
Materials and Methods: A total of 403 female SUI patients who undergone suburethral sling procedure was enrolled in the study. Pre-operative video urodynamics study (VUDS) were performed and they were classified into 3 groups: (i) stable bladder, (ii) DO and (iii) DU. The baseline urodynamic parameters and the therapeutic outcome were compared among three groups. The longest follow up in this study was up to 240 months.
Results: Of a total of 403 participants, 291 (72.2%) had stable bladder, 78(19.4%) had DO and 34 (8.4%) had DU. The overall continence rate was 355 (81.8%), dysuria 79 (18.2%), urge incontinence 15 (3.5%), SUI and required secondary sling was 70 (16.1%) and urethrolysis was 14 (3.2%). The continence rate in stable bladder group was 84.5%, 80.8% in DO group and 79.4% in DU group, p=0.59. The therapeutic outcome of different bladder functions was shown in Table 1. Figure 1. Using Kaplan-Meier survival analysis, patients with stable bladder had the most sustainable cure rate for SUI, followed by patients with DO and lastly DU, p=0.39.
Conclusion: The overall continence rate was 83.4% and the 10-year continence rate achieved at least 72.9%. Pre-operative urodynamic study for bladder function could not determine the therapeutic outcome in patients with SUI.