评估无张力阴道带和经闭带手术在一年内进行的网片侵蚀

Elif Yıldız, Burcu Timur
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引用次数: 0

摘要

背景/目的:补片糜烂是补片手术中最可怕的并发症之一,随着补片手术的增多,其发生频率也在不断增加。本研究旨在从临床效果和补片糜烂两方面评价我院在外科治疗压力性尿失禁(SUI)中采用的经通气带(TOT)和无张力阴道带(TVT)手术。方法:本研究为回顾性队列研究。回顾我院2022年1月至2023年1月间50例SUI患者行TOT和TVT手术的资料。诊断为单纯SUI并接受手术治疗的患者纳入我们的研究。参与者被分为两组:一组做过TVT手术,另一组做过TVT手术。这些组在补片损伤、补片糜烂、盆腔疼痛、性交困难症状和尿潴留方面进行评估和比较。记录患者手术资料、并发症发生率、术前术后尿失禁影响问卷(IIQ-7)及国际尿失禁问卷简表(ICIQ-SF)评分。结果:参与者的平均随访时间为8.96(8.47)(范围6-17个月)。TVT手术13例,TOT手术37例。两组比较,年龄、体重指数(BMI)、胎次、绝经状态、尿失禁持续时间、术前IIQ-7评分、ICIQ-SF评分差异均无统计学意义(P<0.05)。两组手术时间、住院时间、手术早期并发症、术后第3个月IIQ-7、ICIQ-SF评分差异无统计学意义(P<0.05)。此外,两组间补片糜烂率和补片相关并发症发生率无差异(P<0.05)。结论:TOT和TVT手术在并发症方面是相当安全的,在患者满意度方面是令人满意的。虽然网片相关的并发症可能是可怕的,但通过适当的管理,恢复率很低。我们的研究结果表明,当外科医生有反失禁手术的经验时,这两种手术都是安全的,并发症发生率是可以接受的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of tension-free vaginal tape and transobturator tape surgery performed in one year in terms of mesh erosion
Background/Aim: Mesh erosion is one of the feared complications in surgeries performed using mesh, and its frequency is increasing as more and more of these surgeries are performed. This study aims to evaluate transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries performed in the surgical treatment of stress urinary incontinence (SUI) in our clinic in terms of clinical results and mesh erosion. Methods: This study is a retrospective cohort study. The files of 50 patients who had SUI and underwent TOT and TVT surgery in our clinic between January 2022 and January 2023 were reviewed. Patients diagnosed with pure SUI and for whom surgery was performed were included in our study. The participants were divided into two groups: those who had TOT surgery and those who had TVT surgery. These groups were evaluated and compared in terms of mesh injury, mesh erosion, pelvic pain, dyspareunia symptoms, and urinary retention. The surgical data of patients, incidence of complications, pre- and postoperative incontinence impact questionnaires (IIQ-7) and the scores of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were recorded. Results: The mean follow-up period of the participants was 8.96 (8.47) (range, 6-17 months). TVT surgery was performed on 13 participants and TOT surgery was performed on 37 patients. When the two groups were compared, there was no statistically significant difference in terms of age, body mass index (BMI), parity, menopausal status, duration of incontinence, preoperative IIQ-7 scores, and ICIQ-SF scores (P<0.05). There were no statistically significant differences between surgical durations, length of hospital stay, early surgical complications, postoperative 3rd month IIQ-7, and ICIQ-SF scores (P<0.05). Furthermore, no difference in the rates of mesh erosion and mesh-related complications between the two groups (P<0.05) was observed. Conclusion: TOT and TVT surgeries seem to be quite safe in terms of complications, as well as being satisfactory in terms of patient satisfaction. Although mesh-related complications can be frightening, the rate of regression is low with appropriate management. Our results show that both operations are safe with an acceptable complication rate when performed by surgeons who have experience with anti-incontinence procedures.
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