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为什么我们应该停止植入转闭器吊带?

Caroline Thuillier¹, François Meyer², Sandrine Campagne-Loiseau³

¹Department of Urology, 14(e) Hôpital Michallon, University of Grenoble, CHU Grenoble-Alpes, boulevard de la Chantourne, 38700 La Tronche, France.

The French journal of urology

|April 18, 2025

概括

用于骨盆底修复的转闭带 (TOT) 与慢性疼痛和难以移除有关,建议停止使用. 经阴道带 (TVT) 仍然是应激性尿失禁和骨盆器官脱落的更安全,更易于管理的选择.

科学领域:

泌尿和妇科泌尿和妇科
骨盆地板手术骨盆地板手术
生物材料在医学中的应用

背景情况:

自2008年FDA警告以来,合成聚烯用于应激性尿失禁 (SUI) 和骨盆器官脱落 (POP) 的使用一直在争论中.
经阴道带 (TVT) 和转闭带 (TOT) 程序已经显著推进了盆底重建手术.

研究的目的:

为了比较SUI和POP治疗的TVT和TOT程序的安全性和有效性.
评估与TVT和TOT相关的长期并发症率,包括慢性疼痛和修复手术.
提供关于在临床实践中继续使用TOT与TVT的建议.

主要方法:

分析了系统性审查和大型临床试验.
评估了TVT和TOT的比较疗效和并发症率.
检查了有关慢性疼痛,神经陷入困境和脱困难的证据.

主要成果:

TVT和TOT都对SUI和POP有效,子的疗效与伯奇体悬浮等较旧的方法相美,但排泄问题较少.
TOT具有较低的手术内风险,但慢性沟和骨盆疼痛的发生率明显较高,通常与神经陷和难以移除网状组织有关.
与TOT相比,TVT表现出较低的并发症率,并且在出现不良事件时更易于管理.

结论:

与TOT相关的较高的慢性疼痛,重新手术和复杂管理率要求停止TOT.
尽管存在固有的风险,但TVT提供了更好的疗效,可逆性和并发症管理.
未来的临床努力应集中在加强外科医生培训,患者选择和术后护理,以优化盆地重建手术的结果.

关键词:

复杂性复杂性复杂性准则准则准则准则这是一个很棒的网络.变压器的变压器尿失禁 (压力) 的原因

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