{"title":"尿道中段吊带和尿道扩张术治疗女性压力性尿失禁合并尿道狭窄的疗效。","authors":"Yan Qin, Peng Qiao, Xing Guan, Biao Wang","doi":"10.29271/jcpsp.2024.06.702","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential clinical benefits of mid-urethral sling (MUS) and urethral dilatation (UD) operations for the treatment of stress urinary incontinence (SUI) combined with urethral stricture.</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, from January 2017 to 2022.</p><p><strong>Methodology: </strong>Patients with Qmax <15ml/s or PVR >50ml, and video urodynamic study (VUDS) capable of confirming the presence and position of urethral stricture were included. The clinical efficacy was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire, maximum flow rate (Qmax), and postvoid residual (PVR) urine. ICIQ-SF, Qmax, and PVR were measured presurgery, on postoperative 2-week, and 1-month postsurgery.</p><p><strong>Results: </strong>There were total 19 patients with an average age of 61.37 ± 11.28 years (range 39-84) with SUI and urethral stricture. ICIQ-SF scores were decreased significantly at one month postoperatively compared with the preoperative [5.0 (0.0, 7.0) vs. 14.0 (13.0, 15.0), p <0.001]. Qmax was increased dramatically compared with the preoperative [21.3 (14.0, 28.4) vs. 13.0 (8.7,18.0), p <0.001], and PVR was decreased remarkably than the preoperative [0.0 (0.0,0.0) vs. 0.0 (0.0,60.0), p = 0.018]. Of 19 patients primarily managed with MUS and UD, two patients experienced recurrence requiring repetitive dilation till sling excision surgery was conducted, and improvement was evident in one patient after repeating UD.</p><p><strong>Conclusion: </strong>The overall incidence of SUI combined with urethral stricture in women is low. With a success rate of 89.5%, MUS and UD were effective therapies for the co-existence of SUI with urethral stricture, and repeated UD can be performed safely if necessary in long-term follow-up.</p><p><strong>Key words: </strong>Stress urinary incontinence, Urethral stricture, Mid-urethral sling, Urethral dilatation.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of Mid-Urethral Sling and Urethral Dilation for Stress Urinary Incontinence Combined with Urethral Stricture in Women.\",\"authors\":\"Yan Qin, Peng Qiao, Xing Guan, Biao Wang\",\"doi\":\"10.29271/jcpsp.2024.06.702\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the potential clinical benefits of mid-urethral sling (MUS) and urethral dilatation (UD) operations for the treatment of stress urinary incontinence (SUI) combined with urethral stricture.</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, from January 2017 to 2022.</p><p><strong>Methodology: </strong>Patients with Qmax <15ml/s or PVR >50ml, and video urodynamic study (VUDS) capable of confirming the presence and position of urethral stricture were included. The clinical efficacy was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire, maximum flow rate (Qmax), and postvoid residual (PVR) urine. ICIQ-SF, Qmax, and PVR were measured presurgery, on postoperative 2-week, and 1-month postsurgery.</p><p><strong>Results: </strong>There were total 19 patients with an average age of 61.37 ± 11.28 years (range 39-84) with SUI and urethral stricture. ICIQ-SF scores were decreased significantly at one month postoperatively compared with the preoperative [5.0 (0.0, 7.0) vs. 14.0 (13.0, 15.0), p <0.001]. Qmax was increased dramatically compared with the preoperative [21.3 (14.0, 28.4) vs. 13.0 (8.7,18.0), p <0.001], and PVR was decreased remarkably than the preoperative [0.0 (0.0,0.0) vs. 0.0 (0.0,60.0), p = 0.018]. Of 19 patients primarily managed with MUS and UD, two patients experienced recurrence requiring repetitive dilation till sling excision surgery was conducted, and improvement was evident in one patient after repeating UD.</p><p><strong>Conclusion: </strong>The overall incidence of SUI combined with urethral stricture in women is low. With a success rate of 89.5%, MUS and UD were effective therapies for the co-existence of SUI with urethral stricture, and repeated UD can be performed safely if necessary in long-term follow-up.</p><p><strong>Key words: </strong>Stress urinary incontinence, Urethral stricture, Mid-urethral sling, Urethral dilatation.</p>\",\"PeriodicalId\":94116,\"journal\":{\"name\":\"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.29271/jcpsp.2024.06.702\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29271/jcpsp.2024.06.702","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的探讨尿道中段吊带术（MUS）和尿道扩张术（UD）治疗压力性尿失禁（SUI）合并尿道狭窄的潜在临床益处：描述性研究。研究地点和时间：中国北京首都医科大学附属北京朝阳医院泌尿外科，2017年1月至2022年：纳入 Qmax 50ml、视频尿动力学检查（VUDS）能够确认尿道狭窄的存在和位置的患者。临床疗效通过尿失禁国际咨询简表（ICIQ-SF）问卷、最大流速（Qmax）和排尿后残余尿（PVR）进行评估。ICIQ-SF、Qmax和PVR分别在术前、术后两周和术后一个月进行测量：共有 19 名 SUI 和尿道狭窄患者，平均年龄为 61.37 ± 11.28 岁（39-84 岁）。术后一个月的 ICIQ-SF 评分与术前相比明显下降[5.0 (0.0, 7.0) vs. 14.0 (13.0, 15.0)，p 结论：术后一个月的 ICIQ-SF 评分与术前相比明显下降：女性 SUI 合并尿道狭窄的总体发病率较低。MUS 和 UD 的成功率为 89.5%，是治疗 SUI 合并尿道狭窄的有效疗法，在长期随访中，如有必要，可安全地重复进行 UD：压力性尿失禁 尿道狭窄 尿道中段吊带 尿道扩张术
Efficacy of Mid-Urethral Sling and Urethral Dilation for Stress Urinary Incontinence Combined with Urethral Stricture in Women.
Objective: To investigate the potential clinical benefits of mid-urethral sling (MUS) and urethral dilatation (UD) operations for the treatment of stress urinary incontinence (SUI) combined with urethral stricture.
Study design: Descriptive study. Place and Duration of the Study: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, from January 2017 to 2022.
Methodology: Patients with Qmax <15ml/s or PVR >50ml, and video urodynamic study (VUDS) capable of confirming the presence and position of urethral stricture were included. The clinical efficacy was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire, maximum flow rate (Qmax), and postvoid residual (PVR) urine. ICIQ-SF, Qmax, and PVR were measured presurgery, on postoperative 2-week, and 1-month postsurgery.
Results: There were total 19 patients with an average age of 61.37 ± 11.28 years (range 39-84) with SUI and urethral stricture. ICIQ-SF scores were decreased significantly at one month postoperatively compared with the preoperative [5.0 (0.0, 7.0) vs. 14.0 (13.0, 15.0), p <0.001]. Qmax was increased dramatically compared with the preoperative [21.3 (14.0, 28.4) vs. 13.0 (8.7,18.0), p <0.001], and PVR was decreased remarkably than the preoperative [0.0 (0.0,0.0) vs. 0.0 (0.0,60.0), p = 0.018]. Of 19 patients primarily managed with MUS and UD, two patients experienced recurrence requiring repetitive dilation till sling excision surgery was conducted, and improvement was evident in one patient after repeating UD.
Conclusion: The overall incidence of SUI combined with urethral stricture in women is low. With a success rate of 89.5%, MUS and UD were effective therapies for the co-existence of SUI with urethral stricture, and repeated UD can be performed safely if necessary in long-term follow-up.
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