目的:本研究建立了经阴道网状手术后存在排尿功能障碍的尿流曲线形状的预后意义。
方法:这是一项对439例有症状的膀胱膨出患者的回顾性研究,这些患者接受了经阴道网片手术的前壁修复。术前和术后12个月均使用尿流法和排尿后残留来评估排尿功能。将患者分为两组:有和没有术后排尿功能障碍的患者,分析术后排尿功能障碍的预测因素。分析尿流曲线的形状对术后排尿功能障碍的影响。
结果:35名参与者为排尿功能障碍组,而404人在无排尿功能障碍组。多变量分析是通过添加一个中断形曲线,年龄,Qmax,和后空隙残留,在单变量分析中显示出显著差异,发现年龄68岁或以上(比值比[OR]:7.68,95CI1.02-58,p=0.048),发现后排尿残留≥110mL(OR:2.8,95CI1.25-6.29,p=0.013)和间断形曲线(OR:2.47,95CI1.07-5.69,p=0.034)是经阴道网片手术后存在排尿功能障碍的独立危险因素.
结论:经阴道网状手术治疗膀胱膨出后,发现三个变量可以预测排尿功能障碍:老年,过量的后空隙残留,和断续形状的流动曲线。尿流图血流曲线形状有可能成为术后排尿功能障碍的新预测指标。
OBJECTIVE: This study established the prognostic significance of the uroflowmetry flow curve shape in the presence of voiding dysfunction following transvaginal mesh surgery.
METHODS: This is a retrospective study of 439 symptomatic cystocele patients who underwent anterior wall repair with transvaginal mesh surgery. Uroflowmetry and postvoid residual were used to evaluate voiding function both preoperatively and 12 months postoperatively. The patients were divided into two groups: those with and without postoperative voiding dysfunction, and the predictors of postoperative voiding dysfunction were analyzed. The shape of the urine flow curve was analyzed for its influence on the presence of postoperative voiding dysfunction.
RESULTS: Thirty-five participants were in the voiding dysfunction group, while 404 were in the nonvoiding dysfunction group. Multivariate analysis was conducted by adding an interrupted-shaped curve to age, Qmax, and postvoid residual, which showed significant differences in univariate analysis, found that age 68 years or older (odds ratio [OR]: 7.68, 95%CI 1.02-58, p = 0.048), postvoid residual ≥110 mL (OR: 2.8, 95%CI 1.25-6.29, p = 0.013) and interrupted-shaped curve (OR: 2.47, 95%CI 1.07-5.69, p = 0.034) were discovered to be independent risk factors for the presence of voiding dysfunction after transvaginal mesh surgery.
CONCLUSIONS: Following transvaginal mesh surgery for cystocele, three variables were found to be predictive of voiding dysfunction: the old age, excessive postvoid residual, and an interrupted-shaped flow curve. The uroflowmetry flow curve shape has the potential to be a new predictor of postoperative voiding dysfunction.