Impact of Acute or Chronic Post-Void Retention after Midurethral Sling Surgery for Women with Stress Urinary Incontinence: A Systematic Review and Retrospective Analysis of Our Data.
Eva Skuk, David Lukanović, Vojka Lebar, Miha Matjašič, Mateja Lasič, Matija Barbič
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引用次数: 0
Abstract
Objectives: The aim of our study was to analyze the percentage of acute urinary retention (AUR) after midurethral sling (MUS) surgery for stress urinary incontinence). The results of our study directed us to conduct a systemic review (SR) because of the need to consolidate existing knowledge on the incidence and management of postoperative urinary retention (UR).
Design: The first part of the article presents the SR, which was conducted after the retrospective analyses of our data. Participants/Materials: This article presents a retrospective study conducted on a sample of 55 patients who underwent three different types of MUS surgery: TVT-Abbrevo, TVT-O, and single-incision Ophira Mini Sling.
Setting: The study analyzes outcomes at a median 8-year follow-up, focusing on the significance of AUR after MUS surgery.
Methods: SR was conducted using Medline, Cochrane, and Clinical Trials databases, following PRISMA guidelines. The retrospective study involved 55 patients who underwent three types of MUS surgery (TVT-Abbrevo, TVT-O, and Ophira) at our clinic, with a median follow-up of 8 years. Postoperative outcomes, including AUR and residual urine, were assessed using ultrasound, and success was evaluated through the Patient Global Impression of Improvement (PGI-I) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).
Results: The SR has shown that the reported percentage of patients with acute postoperative UR after MUS procedures varies between 1.5% and 6.6%. In our retrospective analyses, 5 patients had AUR after the procedure (9.1%) and required the use of a Foley catheter for several days. All three surgical procedures resulted in similar levels of patient satisfaction at follow-up, as indicated by the PGI-I scores and patients' ICIQ-SF scores. The type of procedure and the patients' ICIQ-SF or PGI-I scores do not significantly correlate with the post-void residual volume.
Limitations: One of the major limitations in our analyses is the lack of any possibility to compare all TVT approaches, including retropubic. A larger sample size would be necessary to draw more definitive conclusions from these observations.
Conclusions: Our SR provides a comprehensive synthesis of previous research on UR after MUS surgery. We noted that many studies fail to consider the possibility of preexisting UR. Clinically significant long-term UR in our cohort of patients was below 100 mL, was not specifically correlated with any type of procedure, and was not statistically correlated with AUR after operation.
目的:分析压力性尿失禁(SUI)患者行中尿道悬吊(MUS)术后急性尿潴留的发生率。我们的研究结果指导我们进行系统回顾(SR),因为需要巩固关于术后尿潴留的发生率和管理的现有知识。设计:文章的第一部分介绍了SR,这是在对我们的数据进行回顾性分析后进行的。参与者/材料:本文对55例接受三种不同类型MUS手术的患者进行了回顾性研究:TVT-Abbrevo, TVT-O和单切口Ophira Mini Sling。背景:本研究分析中位随访8年的结果,重点关注MUS手术后急性尿潴留的意义。方法:采用Medline、Cochrane和临床试验数据库,遵循PRISMA指南进行SR研究。本回顾性研究纳入55例在我院接受三种MUS手术(TVT-Abbrevo、TVT-O和Ophira)的患者,中位随访时间为8年。术后结果,包括急性尿潴留和残留尿,采用超声评估,并通过患者总体改善印象(PGI-I)和国际尿失禁咨询问卷-简表(ICIQ-SF)评估成功。结果:SR显示,报告的MUS手术后急性术后尿潴留患者百分比在1.5%至6.6%之间。在我们的回顾性分析中,5例患者在手术后出现急性尿潴留(9.1%),需要使用Foley导尿管数天。在随访中,所有三种外科手术都产生了相似的患者满意度水平,如PGI-I评分和患者ICIQ-SF评分所示。手术类型和患者ICIQ-SF或PGI-I评分与空腔后残留容积无显著相关。局限性:我们分析的主要局限性之一是缺乏比较所有TVT入路的可能性,包括耻骨后入路。要从这些观察中得出更明确的结论,需要更大的样本量。结论:我们的研究报告综合了以往关于MUS手术后尿潴留的研究。我们注意到许多研究没有考虑到预先存在的尿潴留的可能性。本队列患者临床显著的长期尿潴留低于100 ml,与任何手术类型均无特异性相关,与术后急性尿潴留无统计学相关性。
期刊介绍:
This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.