目的:探讨尿道中段悬吊术(MUS)和尿道扩张术(UD)治疗压力性尿失禁(SUI)合并尿道狭窄的潜在临床疗效。
方法:描述性研究。研究的地点和持续时间:泌尿外科,北京朝阳医院,首都医科大学,北京,中国,从2017年1月到2022年。
方法:Qmax<15ml/s或PVR>50ml的患者,包括能够确认尿道狭窄的存在和位置的视频尿动力学研究(VUDS)。采用国际失禁咨询问卷-简表(ICIQ-SF)问卷评价临床疗效,最大流量(Qmax),和残余尿液(PVR)。ICIQ-SF,Qmax,和PVR进行了术前测量,术后2周,术后1个月.
结果:共有19例SUI和尿道狭窄患者,平均年龄为61.37±11.28岁(范围39-84岁)。术后1个月ICIQ-SF评分较术前显著下降[5.0(0.0,7.0)vs.14.0(13.0,15.0),p<0.001]。与术前相比,Qmax显着增加[21.3(14.0,28.4)与13.0(8.7,18.0),p<0.001],PVR较术前显著降低[0.0(0.0,0.0)vs.0.0(0.0,60.0),p=0.018]。在19例主要接受MUS和UD治疗的患者中,两名患者经历了需要重复扩张的复发,直到进行吊带切除术,1例患者重复UD后明显改善。
结论:女性SUI合并尿道狭窄的总发生率较低。成功率达89.5%,MUS和UD是SUI与尿道狭窄共存的有效疗法,如果需要,在长期随访中可以安全地进行重复UD。
背景:压力性尿失禁,尿道狭窄,尿道中段吊带,尿道扩张。
OBJECTIVE: To investigate the potential clinical benefits of mid-urethral sling (MUS) and urethral dilatation (UD) operations for the treatment of stress urinary incontinence (SUI) combined with urethral stricture.
METHODS: Descriptive study. Place and Duration of the Study: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing,
China, from January 2017 to 2022.
METHODS: Patients with Qmax <15ml/s or PVR >50ml, and video urodynamic study (VUDS) capable of confirming the presence and position of urethral stricture were included. The clinical efficacy was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire, maximum flow rate (Qmax), and postvoid residual (PVR) urine. ICIQ-SF, Qmax, and PVR were measured presurgery, on postoperative 2-week, and 1-month postsurgery.
RESULTS: There were total 19 patients with an average age of 61.37 ± 11.28 years (range 39-84) with SUI and urethral stricture. ICIQ-SF scores were decreased significantly at one month postoperatively compared with the preoperative [5.0 (0.0, 7.0) vs. 14.0 (13.0, 15.0), p <0.001]. Qmax was increased dramatically compared with the preoperative [21.3 (14.0, 28.4) vs. 13.0 (8.7,18.0), p <0.001], and PVR was decreased remarkably than the preoperative [0.0 (0.0,0.0) vs. 0.0 (0.0,60.0), p = 0.018]. Of 19 patients primarily managed with MUS and UD, two patients experienced recurrence requiring repetitive dilation till sling excision surgery was conducted, and improvement was evident in one patient after repeating UD.
CONCLUSIONS: The overall incidence of SUI combined with urethral stricture in women is low. With a success rate of 89.5%, MUS and UD were effective therapies for the co-existence of SUI with urethral stricture, and repeated UD can be performed safely if necessary in long-term follow-up.
BACKGROUND: Stress urinary incontinence, Urethral stricture, Mid-urethral sling, Urethral dilatation.