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在子宫肌瘤的程序性干预后,盆地症状的变化:系统性审查
Ankita Gupta1, Ethan M Balk, Stacy M Lenger
1Division of Female Pelvic Medicine & Reconstructive Surgery, University of Louisville Health, and the Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics, Gynecology, & Women's Health, University of Louisville School of Medicine, Louisville, Kentucky; the Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island; the Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Northwestern Medicine, Chicago, Illinois; the Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, and the Division of Female Pelvic Medicine and Reconstructive Surgery, Urology Institute, University Hospitals, Cleveland, Ohio; the Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, the Department of OBGYN, Division of Urogynecology, UT Health Science Center at San Antonio, San Antonio, and the Division of Urogynecology, Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas; the Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; the Department of Obstetrics and Gynecology, Jacobi Medical Center, and the Albert Einstein College of Medicine, Bronx, New York; the Department of Obstetrics and Gynecology, University of California, Riverside School of Medicine, Riverside, and KPC Healthcare, Hemet, California; the Jawaharlal Nehur Medical College, Belgaum, India; and the Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico.
对于子宫肌瘤的程序性干预改善了尿路困扰和生活质量. 然而,症状的缓解程度差异很大,只有有限的数据可以比较不同的程序或长期结果.
科学领域:
- 妇科 妇科 妇科 妇科
- 泌尿和妇科 泌尿和妇科
- 医疗干预 医疗干预
背景情况:
- 子宫瘤是常见的良性瘤,可以引起显著的盆地症状.
- 有各种不同的手术和放射治疗程序可用于瘤管理.
- 这些干预措施对盆地症状的影响需要系统评估.
研究的目的:
- 系统地审查子宫瘤手术干预措施对盆地症状的影响.
- 综合关于不同瘤治疗对于尿路和肠道功能障碍的疗效的证据.
主要方法:
- 通过PubMed,EMBASE和ClinicalTrials.gov进行了系统性审查,直到2023年1月.
- 包括任何设计在leiomyoma手术前后报告盆地症状的研究.
- 在可行的情况下,进行了元分析,并进行了偏差风险评估.
主要成果:
- 来自32项研究 (6项RCT) 的中等质量的证据表明,瘤手术减少了症状困扰 (UDI-6) 并改善了生活质量 (IIQ-7).
- 尿路症状的缓解有显著差异 (7.6-100%),改善率在研究中从19.0-87.5%不等.
- 报道的肠道症状不一致,比较不同程序或长期结果的数据有限.
结论:
- 对于子宫肌瘤的程序性干预与改善尿路症状和生活质量有关.
- 研究之间存在很高的异质性,需要进一步的研究来比较特定的程序并评估长期影响.
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