{"title":"阴道手术网具对英国初级保健中疼痛门诊和心理服务转诊、抗炎测试和盆腔扫描的长期影响:临床实践研究数据链接的一项队列研究","authors":"Emily McFadden, Carl Heneghan","doi":"10.1111/1471-0528.17828","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To examine long-term complications in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP), with and without surgical mesh implants.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Longitudinal open cohort study from 1 April 2006 (or 1 April 2012) to 30 November 2018.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>The Clinical Practice Research Datalink (CPRD) Gold database, which is linked to Hospital Episodes Statistics (HES) inpatient data, the HES Diagnostic Imaging Dataset (DID), Office for National Statistics mortality data and Index of Multiple Deprivation socio-economic status data.</p>\n </section>\n \n <section>\n \n <h3> Sample</h3>\n \n <p>Women aged ≥18 years with a diagnostic SUI/POP Read code.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Rates are estimated using negative binomial regression.</p>\n </section>\n \n <section>\n \n <h3> Main outcome measures</h3>\n \n <p>Rates of referrals for: psychological and pain services; urinalysis, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) testing; and pelvic ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A cohort of 220 544 women were eligible for inclusion; 74% (<i>n</i> = 162 687) had SUI, 37% (<i>n</i> = 82 123) had POP and 11% (<i>n</i> = 24 266) had both. Rates of psychological referrals and CT scans were lower in women with SUI mesh surgery, but this was offset by higher rates of CRP testing in women with SUI or POP mesh, MRI scans in women with SUI mesh, and urinalysis testing and referrals to pain clinics for women with POP mesh.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our results suggest a higher burden of morbidity in women with SUI/POP mesh surgery, and that these women may require ongoing follow-up in the primary care setting.</p>\n </section>\n </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17828","citationCount":"0","resultStr":"{\"title\":\"The long-term impact of vaginal surgical mesh devices on pain clinic and psychological service referrals, anti-inflammatory testing and pelvic scans in UK primary care: A cohort study with the Clinical Practice Research Datalink\",\"authors\":\"Emily McFadden, Carl Heneghan\",\"doi\":\"10.1111/1471-0528.17828\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To examine long-term complications in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP), with and without surgical mesh implants.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Longitudinal open cohort study from 1 April 2006 (or 1 April 2012) to 30 November 2018.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>The Clinical Practice Research Datalink (CPRD) Gold database, which is linked to Hospital Episodes Statistics (HES) inpatient data, the HES Diagnostic Imaging Dataset (DID), Office for National Statistics mortality data and Index of Multiple Deprivation socio-economic status data.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Sample</h3>\\n \\n <p>Women aged ≥18 years with a diagnostic SUI/POP Read code.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Rates are estimated using negative binomial regression.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main outcome measures</h3>\\n \\n <p>Rates of referrals for: psychological and pain services; urinalysis, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) testing; and pelvic ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A cohort of 220 544 women were eligible for inclusion; 74% (<i>n</i> = 162 687) had SUI, 37% (<i>n</i> = 82 123) had POP and 11% (<i>n</i> = 24 266) had both. 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引用次数: 0
摘要
目的研究患有压力性尿失禁(SUI)和盆腔器官脱垂(POP)的女性在植入和未植入手术网片的情况下的长期并发症.设计2006年4月1日(或2012年4月1日)至2018年11月30日的纵向开放队列研究.设置临床实践研究数据链(CPRD)黄金数据库,该数据库与医院发病统计(HES)住院病人数据、HES诊断成像数据集(DID)、国家统计局死亡率数据和多重贫困指数社会经济状况数据相连接。主要结果测量转诊率:心理和疼痛服务;尿液分析、C反应蛋白(CRP)和红细胞沉降率(ESR)检测;盆腔超声波、计算机断层扫描(CT)和磁共振成像(MRI)扫描。结果220 544名妇女符合纳入条件,其中74%(n = 162 687)患有SUI,37%(n = 82 123)患有POP,11%(n = 24 266)同时患有SUI和POP。接受 SUI 网片手术的妇女接受心理转诊和 CT 扫描的比例较低,但接受 SUI 或 POP 网片手术的妇女接受 CRP 检测的比例较高,接受 SUI 网片手术的妇女接受 MRI 扫描的比例较高,接受 POP 网片手术的妇女接受尿液分析检测和疼痛诊所转诊的比例较高,从而抵消了上述比例。
The long-term impact of vaginal surgical mesh devices on pain clinic and psychological service referrals, anti-inflammatory testing and pelvic scans in UK primary care: A cohort study with the Clinical Practice Research Datalink
Objective
To examine long-term complications in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP), with and without surgical mesh implants.
Design
Longitudinal open cohort study from 1 April 2006 (or 1 April 2012) to 30 November 2018.
Setting
The Clinical Practice Research Datalink (CPRD) Gold database, which is linked to Hospital Episodes Statistics (HES) inpatient data, the HES Diagnostic Imaging Dataset (DID), Office for National Statistics mortality data and Index of Multiple Deprivation socio-economic status data.
Sample
Women aged ≥18 years with a diagnostic SUI/POP Read code.
Methods
Rates are estimated using negative binomial regression.
Main outcome measures
Rates of referrals for: psychological and pain services; urinalysis, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) testing; and pelvic ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans.
Results
A cohort of 220 544 women were eligible for inclusion; 74% (n = 162 687) had SUI, 37% (n = 82 123) had POP and 11% (n = 24 266) had both. Rates of psychological referrals and CT scans were lower in women with SUI mesh surgery, but this was offset by higher rates of CRP testing in women with SUI or POP mesh, MRI scans in women with SUI mesh, and urinalysis testing and referrals to pain clinics for women with POP mesh.
Conclusions
Our results suggest a higher burden of morbidity in women with SUI/POP mesh surgery, and that these women may require ongoing follow-up in the primary care setting.
期刊介绍:
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.