Background Inside out transobturator vaginal tape （TVT-O） and tension-free vaginal tape （TVT） are predominant surgical treatments for female stress urinary incontinence. This meta-analysis evaluated the complicati...Background Inside out transobturator vaginal tape （TVT-O） and tension-free vaginal tape （TVT） are predominant surgical treatments for female stress urinary incontinence. This meta-analysis evaluated the complications and cure rates of TVT-O versus TVT. Methods A comprehensive literature search was conducted according to the Cochrane Collaboration methodology to identify randomized controlled clinical trials with no language restriction. Two authors independently assessed papers for eligibility and methodological quality. Estimates were measured by relative risk with 95% confidence intervals. Outcome measures were objective cure, subjective cure and complications. Quality rating for each outcome of the meta-analysis and recommendations were performed by the Grading of Recommendations Assessment, Development, and Evaluation （GRADE） system. Results Twenty randomized controlled trials met the inclusion criteria, and a pooled estimate of effectiveness and complications was made. Relative risks with 95% confidence intervals for pooled effects under the fixed effects model were： 0.20 （0.09-0.45）, for bladder injury, 0.37 （0.16-0.86） for hematoma, and 2.35 （1.57-3.51） for postoperative pain, suggesting an 80% risk reduction of bladder injury, 63% risk reduction of hematoma, and a 1.35% risk elevation for postoperative pain with TVT-O. There was no significant difference between complications of urinary tract infection 1.14 （0.78-1.65）, lower urinary tract symptoms 1.60 （0.67-3.79）, recatheterization 0.93 （0.59-1.44）, and tape erosion 0.90 （0.48-1.67）, total objective cure rate 1.06 （0.39-2.84） and for the subjective cure rate 0.98 （0.93-1.04）. The quality rating for each outcome and recommendations was high for objective cure, bladder injury, hematoma, lower urinary tract symptoms, and tape erosion and moderate for subjective cure, pain, and urinary tract infection. Conclusions TVT-O is associated with a reduced risk of bladder injury and hematoma and an elevated risk of postoperative pain. Other complications, including tape erosion,urinary tract infection, lower urinary tract symptoms, and recatheterization, are similar to those of TVT.展开更多
Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence.Methods From June 2006 to June 2010,135 patients with stress urinar...Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence.Methods From June 2006 to June 2010,135 patients with stress urinary incontinence were treated in Department of Gynecology and Obstetrics of Peking University Shenzhen Hospital.91 cases of them were treated with low frequency electric stimulation and biofeedback therapy (Group A),and the other 44 cases were treated by improved transobturaor tension-free vaginal tape(TVT-O) and TVT-O (Group B).Then,we compared these two groups by whole recovery rate,recovery rate of patients with urge incontinence,charge of treatment and complication,respectively.Results Group B's recovery rate for stress urinary incontinence was 100%.Ⅰ degree stress urinary incontinence in Group A's recovery rate was higher;Ⅱ degree patients' recovery rate for stress urinary incontinence was lower;Ⅲ degree patients' recovery rate was 0%.Only 1 case showed abnormal urine stream;2 cases showed urinary retention,but the symptoms disappeared after the treatment.No significant complication in Group A.There were huge differences of the expense between the two groups.The effect in Group A for patients with urge incontinence was good,but there was no effect shown in Group B.Conclusions The two treatments are safe and effective for stress urinary incontinence,but there are existed prominent differences of the therapeutic efficacy between the two groups.展开更多
文摘Background Inside out transobturator vaginal tape （TVT-O） and tension-free vaginal tape （TVT） are predominant surgical treatments for female stress urinary incontinence. This meta-analysis evaluated the complications and cure rates of TVT-O versus TVT. Methods A comprehensive literature search was conducted according to the Cochrane Collaboration methodology to identify randomized controlled clinical trials with no language restriction. Two authors independently assessed papers for eligibility and methodological quality. Estimates were measured by relative risk with 95% confidence intervals. Outcome measures were objective cure, subjective cure and complications. Quality rating for each outcome of the meta-analysis and recommendations were performed by the Grading of Recommendations Assessment, Development, and Evaluation （GRADE） system. Results Twenty randomized controlled trials met the inclusion criteria, and a pooled estimate of effectiveness and complications was made. Relative risks with 95% confidence intervals for pooled effects under the fixed effects model were： 0.20 （0.09-0.45）, for bladder injury, 0.37 （0.16-0.86） for hematoma, and 2.35 （1.57-3.51） for postoperative pain, suggesting an 80% risk reduction of bladder injury, 63% risk reduction of hematoma, and a 1.35% risk elevation for postoperative pain with TVT-O. There was no significant difference between complications of urinary tract infection 1.14 （0.78-1.65）, lower urinary tract symptoms 1.60 （0.67-3.79）, recatheterization 0.93 （0.59-1.44）, and tape erosion 0.90 （0.48-1.67）, total objective cure rate 1.06 （0.39-2.84） and for the subjective cure rate 0.98 （0.93-1.04）. The quality rating for each outcome and recommendations was high for objective cure, bladder injury, hematoma, lower urinary tract symptoms, and tape erosion and moderate for subjective cure, pain, and urinary tract infection. Conclusions TVT-O is associated with a reduced risk of bladder injury and hematoma and an elevated risk of postoperative pain. Other complications, including tape erosion,urinary tract infection, lower urinary tract symptoms, and recatheterization, are similar to those of TVT.
文摘Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence.Methods From June 2006 to June 2010,135 patients with stress urinary incontinence were treated in Department of Gynecology and Obstetrics of Peking University Shenzhen Hospital.91 cases of them were treated with low frequency electric stimulation and biofeedback therapy (Group A),and the other 44 cases were treated by improved transobturaor tension-free vaginal tape(TVT-O) and TVT-O (Group B).Then,we compared these two groups by whole recovery rate,recovery rate of patients with urge incontinence,charge of treatment and complication,respectively.Results Group B's recovery rate for stress urinary incontinence was 100%.Ⅰ degree stress urinary incontinence in Group A's recovery rate was higher;Ⅱ degree patients' recovery rate for stress urinary incontinence was lower;Ⅲ degree patients' recovery rate was 0%.Only 1 case showed abnormal urine stream;2 cases showed urinary retention,but the symptoms disappeared after the treatment.No significant complication in Group A.There were huge differences of the expense between the two groups.The effect in Group A for patients with urge incontinence was good,but there was no effect shown in Group B.Conclusions The two treatments are safe and effective for stress urinary incontinence,but there are existed prominent differences of the therapeutic efficacy between the two groups.
