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目的探讨阴道单切口可调节AjustTM吊带治疗女性压力性尿失禁的有效性、安全性以及1年后随访情况。方法回顾性分析2012年10月至2014年2月于北京协和医院因压力性尿失禁(SUI)行AjustTM吊带手术并可随访到的患者共31例,其中24例同时进行抗脱垂手术。收集围手术期并发症情况以及术后3个月、12个月门诊随访情况。分别计算术后3个月、12个月及电话随访时的治愈率、改善率及失败率,Wilcoxon符号秩和检验比较IIQ-7、PFDI-20及PISQ-12问卷术前术后评分情况。结果平均随访22(12~29)个月,随访率88%。术后3个月治愈率83.9%,改善率12.9%,失败率3.2%;术后12个月治愈率87.1%,改善率9.7%;失败率3.2%。3例(9.7%)术后新发急迫症状,其中2例为反复泌尿系感染。IIQ-7及PFDI-20问卷术后3个月、12个月评分与术前评分相比均显著降低(P<0.05)。结论 AjustTM吊带术后的中期随访结果显示该术式有较高SUI治愈率及改善率,手术安全性好,无严重并发症出现。
Objective To investigate the effectiveness and safety of a single vaginal incision-adjustable AjustTM sling for female stress urinary incontinence and follow-up one year later. Methods A total of 31 patients who underwent AjustTM sling surgery under pressure urinary incontinence (SUI) from October 2012 to February 2014 in Peking Union Medical College Hospital were retrospectively analyzed. Twenty-four of them were treated with anti-prolapse simultaneously. Perioperative complications were collected and follow-up at 3 months and 12 months postoperatively. The cure rates, improvement rates and failure rates at 3 months, 12 months and telephone follow-up were calculated respectively. Wilcoxon signed-rank test was used to compare the preoperative and postoperative scores of IIQ-7, PFDI-20 and PISQ-12 questionnaires. Results The average follow-up was 22 (12-29) months, with a follow-up rate of 88%. At 3 months after operation, the cure rate was 83.9%, the improvement rate was 12.9% and the failure rate was 3.2%. The cure rate at 12 months was 87.1%, the improvement rate was 9.7% and the failure rate was 3.2%. Three patients (9.7%) had new emergent symptoms after operation, of which 2 were recurrent urinary tract infections. The scores of 3 months and 12 months after IIQ-7 and PFDI-20 questionnaire were significantly lower than those before surgery (P <0.05). Conclusion The mid-term follow-up of AjustTM sling showed that the procedure had higher SUI cure rate and improvement rate, good operation safety and no serious complications.