较短时间的失禁的有效性和安全性
Kjersti Rimstad1,2, Sissel Hegdahl Oversand3,4, Marie Ellström Engh5,6
1Department of Obstetrics and Gynaecology, Akershus University Hospital, PO box 1000, 1478, Lørenskog, Norway. kjersti.rimstad@medisin.uio.no.
International urogynecology journal
|November 13, 2024
概括
较短的 incontinence slings (AjustTM,TVT-A) 比传统的 slings 显示出更糟糕的 incontinence 结果,但并发症较少. 长期的手术后疼痛并没有减少较短的子.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 妇科 妇科 妇科 妇科
- 手术创新 在外科创新.
背景情况:
- 传统的中尿道 (MUS),如无张力阴道带内外遮器 (TVT-O) 和无张力阴道带 (TVT),对应激性尿失禁 (SUI) 有效.
- 然而,这些子可能会导致严重的并发症,促使人们研究使用更少合成材料的替代品.
- AjustTM和TVT-O AbbrevoTM (TVT-A) 代表了新的,更短的吊带设计,旨在降低风险,同时保持有效性.
研究的目的:
- 为了比较较短 (AjustTM,TVT-A) 与传统的6至12个月失败和并发症率.
- 具体评估与这些不同类型的吊带相关的长期术后疼痛风险.
- 评估每个子类别的客观和主观节结果.
主要方法:
- 在2009年至2021年期间,使用挪威女性失禁注册表 (NFIR) 的数据进行了一项大型注册表研究.
- 该研究包括611个AjustTM,2,772个TVT-A和18,612个传统,分析了手术前,手术前和6至12个月后续的数据.
- 失败被定义为客观措施 (压力测试时≥1g泄漏) 和主观措施 (验证的问卷得分≥3);长期疼痛被定义为持续超过3个月.
主要成果:
- 在6-12个月的时间里,较短的杆显示出明显更高的客观 (AjustTM 15.4%,TVT-A 13.5%) 和主观 (AjustTM 23.4%,TVT-A 23.8%) 失败率,相比于传统的杆 (客观7.3%,主观18.8%).
- 虽然AjustTM和TVT-A的整体并发症比传统子 (9.3%) 少 (4.9%,6.5%),但它们并没有减少长期术后疼痛的发生率 (AjustTM 0.8%,TVT-A 1.4%,传统 0.7%).
- 所有发现在调整基线差异后仍然具有统计学意义.
结论:
- 在手术后6-12个月,较短的失禁套 (AjustTM,TVT-A) 显示出较差的主观和客观的失禁结果.
- 这些较新的拖绳设计与传统拖绳相比,总体并发症较少.
- 然而,使用更短的子并不能显著降低长期术后疼痛的风险.
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