METHODS: Retrospective, descriptive, single centre study of women undergoing genital prolapse surgery with Uphold™ LITE mesh insertion between July 2016 and April 2019. Pre-, peri- and 1-year postoperative follow-up data were collected.
RESULTS: Thirty-six women were included (mean age: 72±7years). Most patients (75%) had grade III cystocele and three (8.3%) had recurrent prolapse. Mean operative time was 41±12min. During surgery, no visceral injury or haemorrhagic complications were noted but there were three intraoperative bladder injuries (8.3%). Twelve patients (33.3%) had preoperative SUI, half of which (n=6; 50%) responded to prolapse repair. De novo SUI was noted in 6/24 (25%) patients. The risk of having persistent postoperative SUI was 50% in patients with preoperative SUI, and the risk of developing de novo postoperative SUI was 25% in patients without preoperative SUI. Thus, patients with preoperative SUI were twice as likely to have persistent postoperative SUI as those without preoperative SUI (RR=2.0 [95% CI: 0.8175-4.8928]; P=0.128). Five patients with de novo SUI and three patients with persistent postoperative SUI were subsequently treated with insertion of a mid-urethral sling (MUS). The other patients improved with physiotherapy.
CONCLUSIONS: Risk of persistent SUI after implantation of an Uphold™ LITE mesh is higher in patients with preoperative SUI. Surgical correction with a MUS can be offered in cases of de novo SUI before or after physiotherapy.
METHODS: 4.
方法:回顾性,描述性,描述性2016年7月至2019年4月期间接受Uphold™LITE网状物插入生殖器脱垂手术的女性的单中心研究。Pre-,收集围手术期和术后1年的随访数据。
结果:纳入36名女性(平均年龄:72±7岁)。大多数患者(75%)患有III级膀胱膨出,三名(8.3%)患有复发性脱垂。平均手术时间41±12min。手术期间,未发现内脏损伤或出血并发症,但术中膀胱损伤3例(8.3%).12例(33.3%)患者术前发生SUI,其中一半(n=6;50%)对脱垂修复有反应。在6/24(25%)患者中发现了从头SUI。术前SUI患者术后持续SUI的风险为50%,在没有术前SUI的患者中,从头发生术后SUI的风险为25%。因此,术前有SUI的患者发生持续性术后SUI的可能性是没有术前SUI的患者的两倍(RR=2.0[95%CI:0.8175-4.8928];P=0.128).随后插入中尿道吊带(MUS)治疗了五名从头SUI患者和三名持续术后SUI患者。其他患者通过物理治疗得到改善。
结论:术前SUI患者植入Uphold™LITE网后持续性SUI的风险较高。在物理治疗之前或之后的从头SUI的情况下,可以使用MUS进行手术矫正。
方法:4.