{"title":"预测尿道中吊带治疗混合性尿失禁成功的因素","authors":"Cuneyd Ozkurkcugil, Ibrahim Erkut Avci","doi":"10.1111/luts.12471","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>We aimed to investigate success rates and predictive factors for midurethral slings (MUS) in women with mixed urinary incontinence (MUI).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Women with MUI (urodynamically diagnosed detrusor overactivity and stress urinary incontinence) treated with MUS between 2013 and 2020 were retrospectively investigated. Prior to MUS, all participants completed bladder diary and questionnaires and underwent a urodynamic study. Six months after surgery, patients were evaluated for lower urinary tract symptoms with pelvic examination, pad test, and the 8-item Overactive Bladder Questionnaire (OAB-V8) and the International Consultation on Incontinence Questionnaire-Short-Form (ICIQ-SF). Success rates after MUS were determined separately according to the predominant component of MUI. In addition, multivariable logistic regression analysis was used to determine the most important independent variables affecting the surgical outcome.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>There were 117 participants. The overall MUI cure rate was 73.5%, but surgical success in the presence of postoperative urgency was 60.7%. Moreover, MUS success rate was 84.8% in those with preoperative stress-dominant MUI. However, the success rates for equally and urgency-dominant MUI were both 29.4%. Preoperative OAB-V8 score, symptom duration >9.5 years, and preoperative anticholinergic medication were risk factors for persistent urgency and urgency urinary incontinence (UUI) postoperatively (<i>p</i> < .05). In addition, diabetes mellitus (DM) for persistent urgency and voiding frequency (daily) for persistent UUI were predictive factors (<i>p</i> < .05).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>MUS may be offered to women with stress-dominant MUI. However, postoperative urgency might change a patient's perception of treatment despite successful incontinence treatment. MUS does not appear to be a good option when MUI patients have a high OAB-V8 score, symptom duration >9.5 years, DM, or use of anticholinergic medication preoperatively.</p>\n </section>\n </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"15 2","pages":"50-56"},"PeriodicalIF":1.5000,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors predicting treatment success in mixed urinary incontinence treated with midurethral sling\",\"authors\":\"Cuneyd Ozkurkcugil, Ibrahim Erkut Avci\",\"doi\":\"10.1111/luts.12471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>We aimed to investigate success rates and predictive factors for midurethral slings (MUS) in women with mixed urinary incontinence (MUI).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Women with MUI (urodynamically diagnosed detrusor overactivity and stress urinary incontinence) treated with MUS between 2013 and 2020 were retrospectively investigated. Prior to MUS, all participants completed bladder diary and questionnaires and underwent a urodynamic study. Six months after surgery, patients were evaluated for lower urinary tract symptoms with pelvic examination, pad test, and the 8-item Overactive Bladder Questionnaire (OAB-V8) and the International Consultation on Incontinence Questionnaire-Short-Form (ICIQ-SF). Success rates after MUS were determined separately according to the predominant component of MUI. In addition, multivariable logistic regression analysis was used to determine the most important independent variables affecting the surgical outcome.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>There were 117 participants. The overall MUI cure rate was 73.5%, but surgical success in the presence of postoperative urgency was 60.7%. Moreover, MUS success rate was 84.8% in those with preoperative stress-dominant MUI. However, the success rates for equally and urgency-dominant MUI were both 29.4%. Preoperative OAB-V8 score, symptom duration >9.5 years, and preoperative anticholinergic medication were risk factors for persistent urgency and urgency urinary incontinence (UUI) postoperatively (<i>p</i> < .05). In addition, diabetes mellitus (DM) for persistent urgency and voiding frequency (daily) for persistent UUI were predictive factors (<i>p</i> < .05).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>MUS may be offered to women with stress-dominant MUI. However, postoperative urgency might change a patient's perception of treatment despite successful incontinence treatment. MUS does not appear to be a good option when MUI patients have a high OAB-V8 score, symptom duration >9.5 years, DM, or use of anticholinergic medication preoperatively.</p>\\n </section>\\n </div>\",\"PeriodicalId\":18028,\"journal\":{\"name\":\"LUTS: Lower Urinary Tract Symptoms\",\"volume\":\"15 2\",\"pages\":\"50-56\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2022-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"LUTS: Lower Urinary Tract Symptoms\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/luts.12471\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"LUTS: Lower Urinary Tract Symptoms","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/luts.12471","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Factors predicting treatment success in mixed urinary incontinence treated with midurethral sling
Objectives
We aimed to investigate success rates and predictive factors for midurethral slings (MUS) in women with mixed urinary incontinence (MUI).
Methods
Women with MUI (urodynamically diagnosed detrusor overactivity and stress urinary incontinence) treated with MUS between 2013 and 2020 were retrospectively investigated. Prior to MUS, all participants completed bladder diary and questionnaires and underwent a urodynamic study. Six months after surgery, patients were evaluated for lower urinary tract symptoms with pelvic examination, pad test, and the 8-item Overactive Bladder Questionnaire (OAB-V8) and the International Consultation on Incontinence Questionnaire-Short-Form (ICIQ-SF). Success rates after MUS were determined separately according to the predominant component of MUI. In addition, multivariable logistic regression analysis was used to determine the most important independent variables affecting the surgical outcome.
Results
There were 117 participants. The overall MUI cure rate was 73.5%, but surgical success in the presence of postoperative urgency was 60.7%. Moreover, MUS success rate was 84.8% in those with preoperative stress-dominant MUI. However, the success rates for equally and urgency-dominant MUI were both 29.4%. Preoperative OAB-V8 score, symptom duration >9.5 years, and preoperative anticholinergic medication were risk factors for persistent urgency and urgency urinary incontinence (UUI) postoperatively (p < .05). In addition, diabetes mellitus (DM) for persistent urgency and voiding frequency (daily) for persistent UUI were predictive factors (p < .05).
Conclusions
MUS may be offered to women with stress-dominant MUI. However, postoperative urgency might change a patient's perception of treatment despite successful incontinence treatment. MUS does not appear to be a good option when MUI patients have a high OAB-V8 score, symptom duration >9.5 years, DM, or use of anticholinergic medication preoperatively.
期刊介绍：
LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided.
LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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