Needleless Contasure versus TVT-O in Women with Stress Urinary Incontinence

Objectives: The aim of this thesis is to determine the clinical effectiveness, safety and cost-effectiveness of Single Incision needleless Mini-Slings compared with tension-free Standard Mid-urethral Sling in the surgical management of female stress urinary incontinence, but with less side effects. Methods: The study will be conducted in Zagazig University Hospitals. From 2018 to Sept. 2019, 40 cases were enrolled in the study and were randomized by envelope technique at the time of surgery to either a trans-obturator vaginal tape (TOT) or Needleless anti-incontinence procedure. The patients will be divided into 2 groups: Group 1 patient treated by standard sling (TOT). Group 2 those treated by mini-sling. Parameters in perioperative period such as operating time, intraoperative hemorrhage volume, length of stay in hospital, intraoperative complications, and postoperative pain of each patient were recorded. The sample size was calculated to be 40 cases (20 cases will be treated by standard slings, 20 case will be treated by mini-sling). Results: A total of 40 patients assessed for eligibility were randomized into Needleless groups. There were no significant differences in age, body mass index, process, parity, pad test or the assessment of preoperative quality of life between the two groups. In the perioperative period, statistically significant differences between the two groups were found in operating time, intraoperative hemorrhage volume, groin pain scores at 24 h after operation and length of stay in hospital (P < 0.001). After two weeks of follow-up, a statistically significant difference between the two groups was found in groin pain/femori-bus internus pain scores, but there were no significant differences in cure rates, pad test, complications or ICIQ-SF. After 1 year, there were no significant differences between the Needleless and TOT groups in cure rates, pad test, groin pain or ICIQ-SF (P > 0.05). Both groups registered a significant improvement in the quality of life (P < 0.001), but there were no significant differences between the two groups (P > 0.05). Conclusion: We conclude that compared with the TOT surgery, single-incision Needleless sling in the treatment of female stress urinary incontinence is simpler and quicker and has less hemorrhage during surgery as well as faster recovery and it also can obviously reduce the inguinal region pains after operation and shorten hospital stays. In summary, single-incision Needleless sling is a kind of convenient, safe and effective minimally invasive surgery for urinary incontinence.

无针吊带技术在治疗女性压力性尿失禁的临床应用研究

尿失禁是中老年女性的常见病和多发病,尿道中段悬吊带技术被认为是治疗女性压力性尿失禁的金标准。多中心临床研究,多年手术后随访证明单切口TOT无针吊带技术是一种安全、有效、副作用少、并发症少、易学易用、病人易于接受的实用技术。对手术后患者包括性生活在内的生活质量有明显改善,是一种值得推广普及的技术。

Contasure Needleless~无针吊带应用于女性压力性尿失禁患者的效果评价

目的探讨Contasure Needleless~无针吊带对女性压力性尿失禁(SUI)患者的临床治疗效果。方法筛选并纳入2014年3月—2016年2月浙江大学明州医院和宁波妇儿医院收治的女性SUI患者148例作为研究对象。应用随机数字表法将全部患者随机分为2组,观察组行Contasure Needleless~治疗,对照组行经闭孔无张力尿道中段悬吊术(TVT-O)治疗。评价2组患者的临床治疗效果、围手术期相关指标(手术时间、术中出血量、术后24 h疼痛、住院时间,术后感染、尿潴留、血肿)、术后生活质量的改善及并发症的发生率。结果 (1)治疗效果:观察组中85.7%治愈,8.6%缓解,5.7%无效,对照组分别为89.7%、5.9%、4.4%,2组总有效率比较差异无统计学意义(P>0.05)。(2)围术期相关指标:观察组手术时间、术中出血量及术后24 h疼痛评分均明显优于对照组(t=21.602、6.147、3.470,P<0.05)。(3)术后生活质量的改善:2组患者术后ICIQ-SF、IIQ-7、UDI-6等生活质量评分指标比较差异均无统计学意义(P>0.05)。(4)并发症的发生率:观察组并发症总发生率为8.11%(6/74);对照组为17.57%(13/74),2组比较差异有统计学意义(χ~2=4.000,P=0.045)。结论 Contasure Needleless~无针吊带治疗我国女性SUI疗效与TVT-O相当,但其具有手术时间短、术中出血少、腹股沟区疼痛发生率低的临床优势,值得在我国各级医院推广实施。

单切口无针吊带治疗女性压力性尿失禁的效果及安全性

目的评估单切口无针吊带治疗女性压力性尿失禁(SUI)的临床疗效及安全性。方法选取2015年1月至2017年1月接受手术治疗的37例压力性尿失禁患者的临床资料,其中单纯型压力性尿失禁27例,混合型10例。年龄32～78岁,平均53. 1岁;病史1～20年,平均6. 1年;随访时间7～24个月,平均15. 3个月。所有患者手术前后均填写国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)、尿失禁影响问卷简表(IIQ-7)、有性生活患者手术前后填写性生活质量问卷简表(PISQ-12)。采用Wilcoxon符号秩和检验比较围手术期评分情况。结果 37例患者在局部麻醉下完成手术,术后3个月治愈30例(81. 1%),改善6例(16. 2%),失败1例(2. 7%);术后12个月治愈29例(78. 4%),改善7例(19. 4%),治疗总有效率为97. 3%,失败1例(2. 7%)。IIQ-7及ICIQ-SF问卷术后3、12个月评分与术前相比均显著降低,差异有统计学意义(P <0. 05)。有性生活患者术后PISQ-12评分增高,与术前评分相比差异有统计学意义(P <0. 05)。结论单切口Needleless无针吊带术操作简单,更加微创,并发症发生更少,是治疗女性压力性尿失禁的有效术式。