目的 分析老年子宫脱垂患者术后新发压力性尿失禁(de novo SUI)情况及其影响因素。方法 回顾性分析泗县人民医院2020年10月~2023年5月期间因子宫脱垂行手术治疗的60例患者,调查患者术后de novo SUI发生情况,将患者分为无de novo SUI组及...目的 分析老年子宫脱垂患者术后新发压力性尿失禁(de novo SUI)情况及其影响因素。方法 回顾性分析泗县人民医院2020年10月~2023年5月期间因子宫脱垂行手术治疗的60例患者,调查患者术后de novo SUI发生情况,将患者分为无de novo SUI组及de novo SUI组,通过单因素及多因素logistic回归分析影响患者术后de novo SUI发生的相关因素。结果 60例行手术治疗的子宫脱垂患者,18例患者术后发生de novo SUI,发病率为30.00%。单因素分析结果显示,体质量指数(BMI)、高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史、雌激素治疗史是影响老年子宫脱垂患者术后de novo SUI的相关因素(χ^(2)=5.701、4.775、6.782、4.113、3.951、5.644、9.966,P<0.05)。多因素logistic分析结果显示,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素(P<0.05)。结论 老年子宫脱垂患者术后存在一定的de novo SUI发生风险,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素。展开更多
Background：Although repair augmented with mesh has been proved its priority in anatomical and functional recovery after anterior compartment reconstruction,the data about posterior compartment are scarce.The aim of t...Background：Although repair augmented with mesh has been proved its priority in anatomical and functional recovery after anterior compartment reconstruction,the data about posterior compartment are scarce.The aim of this study was to compare bowel functional outcome of posterior vaginal compartment repair with and without mesh in patients with pelvic organ prolapse （POP）.Methods：This was a prospective,double-blind,clinical pilot study of 22 postmenopausal women with symptomatic POP （overall POP-quantification [POP-Q] Stage Ⅲ-ⅣV） who underwent total pelvic floor reconstruction.Patients were grouped according to the use of mesh for posterior vaginal compartment repair：A mesh group and a nonmesh group.POP-Q stage,the pelvic floor impact questionnaire short form-7 （PFIQ-7） and anorectal manometry were evaluated before and 3 months after surgery.Anatomical success was defined as POP-Q Stage Ⅱ or less.A t-test was used to compare preoperative with postoperative data in the two groups.Results：Totally,17 （71％） were available for the follow-up.POP-Q measurements improved significantly compared to baseline （P ＜ 0.05） in both groups.No recurrence was observed.Subjects in both groups reported improvement in pelvic floor symptoms,and there was no significant difference in the PFIQ-7 score between groups at follow-up （P ＞ 0.05）.Compared with baseline,the nonmesh group exhibited a statistically significant decrease in anal residual pressure,a significant increase in the anorectal pressure difference during bowel movement,and a reduced rate ofdyssynergia defecation pattern （P ＜ 0.05）.Conclusions：Provided there is sufficient support for the anterior wall and apex of vagina with mesh,posterior compartment repair without mesh may be as effective as repair with mesh for anatomical recovery while providing better anorectal motor function.展开更多
文摘目的 分析老年子宫脱垂患者术后新发压力性尿失禁(de novo SUI)情况及其影响因素。方法 回顾性分析泗县人民医院2020年10月~2023年5月期间因子宫脱垂行手术治疗的60例患者,调查患者术后de novo SUI发生情况,将患者分为无de novo SUI组及de novo SUI组,通过单因素及多因素logistic回归分析影响患者术后de novo SUI发生的相关因素。结果 60例行手术治疗的子宫脱垂患者,18例患者术后发生de novo SUI,发病率为30.00%。单因素分析结果显示,体质量指数(BMI)、高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史、雌激素治疗史是影响老年子宫脱垂患者术后de novo SUI的相关因素(χ^(2)=5.701、4.775、6.782、4.113、3.951、5.644、9.966,P<0.05)。多因素logistic分析结果显示,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素(P<0.05)。结论 老年子宫脱垂患者术后存在一定的de novo SUI发生风险,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素。
文摘Background：Although repair augmented with mesh has been proved its priority in anatomical and functional recovery after anterior compartment reconstruction,the data about posterior compartment are scarce.The aim of this study was to compare bowel functional outcome of posterior vaginal compartment repair with and without mesh in patients with pelvic organ prolapse （POP）.Methods：This was a prospective,double-blind,clinical pilot study of 22 postmenopausal women with symptomatic POP （overall POP-quantification [POP-Q] Stage Ⅲ-ⅣV） who underwent total pelvic floor reconstruction.Patients were grouped according to the use of mesh for posterior vaginal compartment repair：A mesh group and a nonmesh group.POP-Q stage,the pelvic floor impact questionnaire short form-7 （PFIQ-7） and anorectal manometry were evaluated before and 3 months after surgery.Anatomical success was defined as POP-Q Stage Ⅱ or less.A t-test was used to compare preoperative with postoperative data in the two groups.Results：Totally,17 （71％） were available for the follow-up.POP-Q measurements improved significantly compared to baseline （P ＜ 0.05） in both groups.No recurrence was observed.Subjects in both groups reported improvement in pelvic floor symptoms,and there was no significant difference in the PFIQ-7 score between groups at follow-up （P ＞ 0.05）.Compared with baseline,the nonmesh group exhibited a statistically significant decrease in anal residual pressure,a significant increase in the anorectal pressure difference during bowel movement,and a reduced rate ofdyssynergia defecation pattern （P ＜ 0.05）.Conclusions：Provided there is sufficient support for the anterior wall and apex of vagina with mesh,posterior compartment repair without mesh may be as effective as repair with mesh for anatomical recovery while providing better anorectal motor function.
