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Catherine A Matthews1, Charles R Rardin2, Andrew Sokol3
1Department of Urology, Wake Forest Baptist Health, Winston Salem, NC.
American journal of obstetrics and gynecology
|May 5, 2024
概括
单切口子在接受骨盆器官脱落修复的妇女治疗应激性尿失禁时,不劣于形子. 在这两种子类型之间,尿的并发症和治疗没有区别.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 妇科 妇科医生 妇科
- 骨盆地板手术 骨盆地板手术
背景情况:
- 中泌尿器吊带的选择影响了女性经过阴道外原生组织修复的女性的疗效和并发症.
- 压力尿失禁 (SUI) 是一种常见的疾病,在骨盆重建手术期间经常使用尿道中间进行管理.
研究的目的:
- 为了确定单切口螺丝是否不劣于形螺丝,用于在接受阴道修复的患者中管理SUI.
- 为了比较单片切口和形之间的不良事件和外科医生的易用性.
主要方法:
- 一个多中心,非劣势性,随机化试验,涉及患有骨盆器官脱落 (第二阶段或更高) 和证实SUI的妇女.
- 与阴道修复并发的随机化为单切口 (阿尔蒂斯吊带) 或逆管吊带.
- 主要结局:12个月后下泌尿道功能异常;次要结局:不良事件,患者满意度和外科医生易于使用.
主要成果:
- 在异常下泌尿道功能方面,单切口螺丝丝是不劣于后螺丝的 (25%对20%,P=.001为非劣质).
- 在麻烦的SUI,重复治疗率或不良事件 (包括新紧急情况,尿路感染,网状暴露,长时间导管或疼痛) 中没有发现显著差异.
- 患者的满意度是相似的 (71%与67%对比),但形形被评为更容易被外科医生使用 (中位数为9与8,P=.03).
结论:
- 单切口是一种可行的替代品,用于管理女性进行阴道修复的SUI.
- 这两种带类型在该患者群体中对SUI管理的有效性和安全性表现相似.
- 外科医生的易用性有利于回流管,但这没有影响患者的治疗结果或整体并发症率.
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