莫斯科国立医科和牙科大学A.I. Yevdokimov泌尿外科诊所治疗压力性尿失禁的经验

M. Gvozdev, M. Dzhuraeva, O. Arefyeva, D. Pushkar
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All patients were invited for follow-up visits: 1 month, 1 year after surgery. Results: After 1 month after surgery, a negative cough test was recorded in 58 patients (85.3%). Fifty-nine patients (86.8%) had no residual volume. 3 patients (4.4%) reported pelvic pain after surgery. In 5 patients (7.4%), signs of overactive bladder appeared. 49 patients (72.1%) were pleased with the result of the surgery, 13 patients (19.1%) were satisfied with the results of the surgery, 6 patients (8.8%) were dissatisfied with the results of treatment. After 12 months after the surgery, a negative cough test was observed in 55 patients (87.3%). We did not observe any recurrence of urinary incontinence. Two patients (3.2%) had a residual volume of fewer than 100 mL. 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摘要

背景:泌尿外科吊带干预术的发明使压力性尿失禁的治疗向前迈进了一大步。然而,手术成功率高的同时,并发症的发生率也高,这就要求泌尿科医生的手术技巧不断提高。因此,减少与组织的相互作用可以提供更少的破坏性效果和可持续的效果中尿道吊带手术。本研究评估了在我们的实践中最常用的迷你吊索的有效性。方法:研究纳入2010年2月至2012年7月期间接受该手术干预的患者。共有68名患者参加了这项研究。患者平均年龄58.7岁(范围31 ~ 85岁)。所有患者于术后1个月、1年随访。结果:术后1个月咳嗽试验阴性58例(85.3%)。59例(86.8%)患者无残留体积。术后盆腔疼痛3例(4.4%)。5例(7.4%)患者出现膀胱过度活动的征象。49例患者(72.1%)对手术结果满意,13例患者(19.1%)对手术结果满意,6例患者(8.8%)对治疗结果不满意。术后12个月咳嗽试验阴性55例(87.3%)。我们没有观察到任何尿失禁复发。2例(3.2%)患者残留容量小于100 mL。2例(3.2%)患者有膀胱过度活动综合征。1例(1.6%)患者仍有盆腔疼痛。50例患者对手术结果满意(79.4%),9例患者对治疗结果满意(14.3%),4例患者对治疗结果不满意(6.3%)。结论:该胶带可用于既往手术后复发性尿失禁的患者,适用于闭孔或耻骨后路径。通过正确选择手术患者,充分的术前评估和计划,以及根据其步骤直接进行干预,迷你吊索Ophira在手术治疗压力性尿失禁中成功率高,并发症发生率低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mini-sling Ophira in treatment of stress urinary incontinence: experience of the Urology Clinic of A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Background: The invention of the sling interventions in urology made a big step forward in the cure of stress urinary incontinence. Nevertheless, with high success outcomes came high rates of complications, that requested evolvement of urologists’ surgical skills. Therefore, a decrease of interaction with a tissue can provide a less damaging effect and sustainable effect of the mid-urethral sling surgery. This study evaluates the effectiveness of the most commonly used mini-sling Ophira in our practice. Methods: The study included patients who underwent this surgical intervention in the period from February 2010 to July 2012. A total of 68 patients took part in the study. The mean age of the patients was 58,7 years (range, 31–85 years). All patients were invited for follow-up visits: 1 month, 1 year after surgery. Results: After 1 month after surgery, a negative cough test was recorded in 58 patients (85.3%). Fifty-nine patients (86.8%) had no residual volume. 3 patients (4.4%) reported pelvic pain after surgery. In 5 patients (7.4%), signs of overactive bladder appeared. 49 patients (72.1%) were pleased with the result of the surgery, 13 patients (19.1%) were satisfied with the results of the surgery, 6 patients (8.8%) were dissatisfied with the results of treatment. After 12 months after the surgery, a negative cough test was observed in 55 patients (87.3%). We did not observe any recurrence of urinary incontinence. Two patients (3.2%) had a residual volume of fewer than 100 mL. Two patients (3.2%) had overactive bladder syndrome. 1 patient (1.6%) still had pelvic pain. 50 patients (79.4%) were pleased with the result of the surgery, 9 patients were satisfied with the treatment results (14.3%), 4 patients (6.3%) were dissatisfied with the treatment results. Conclusions: This tape can be implanted in patients with recurrent urinary incontinence after previous surgeries, where obturator or retropubic route was used. With the right choice of patients for this operation, adequate preoperative assessment, and planning, as well as direct performance of the intervention according to its steps, mini-sling Ophira provides high success efficiency and a low rate of complications in the surgical treatment of stress urinary incontinence.
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