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De-Yi Luo Kun-Jie Wang Han-Chao Zhang Yi Dai Tong-Xing Yang Hong Shen 《The Kaohsiung journal of medical sciences》2014,30(3):139-145
Several midurethral sling (MUS) procedures, such as tension-free vaginal tape (TVT), TVT obturator (TVT-O), tension-free vaginal tape SECUR (TVT-S), and pubovaginal sling (PVS), have been used for the treatment of female stress urinary incontinence (SUI); however, which method is best for a particular patient group is not known. This study aimed to identify the best rationale for choosing the optimal MUS procedure for each patient. In total, 453 consecutive female patients with SUI who were treated with MUSs in West China Hospital of Sichuan University from September 2003 to September 2011 were enrolled in this study. All the patients underwent comprehensive pre-, intra-, and postoperative evaluations, including collection of demographic information, pelvic examination, and urodynamic testing, and operation-related complications were recorded. The Incontinence Quality of Life questionnaire was also completed. Under local or general anesthesia, 105 cases were treated with TVT, 243 with TVT-O, 90 with TVT-S, and 15 with PVS. Patients with different profiles in terms of age, symptom duration, concomitant procedures, urodynamic parameters, and pelvic organ prolapse (POP) quantification score were treated successfully; the body mass index did not differ significantly among the various treatment options. The cure and improvement rates were similar among the treatment groups: 97.14% (102/105) in TVT, 100% (243/243) in TVT-O, 98.89% (89/90) in TVT-S, and 100% (15/15) in PVS. Only minor complications were experienced by the patients. In conclusion, each MUS procedure was observed to be safe and effective in different subpopulations of patients, and the results suggest that appropriate patient selection is crucial for the success of each MUS procedure. 相似文献
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Alois Martan Kamil Svabík Jaromir Masata Tomas Koleska Rachid El-Haddad Marketa Pavlikova 《European journal of obstetrics, gynecology, and reproductive biology》2009
Objective
The aim of this study is to present our first experience with a novel modification of the tension-free sling idea and to evaluate the safety and efficacy of this new procedure for the treatment of stress urinary incontinence in women.Study design
Eighty-five women with previously untreated stress urinary incontinence were recruited to participate in a clinical study. The efficacy of this surgical procedure was evaluated perioperatively and 3 months (±1 week) after operation—objectively by cough test and subjectively by the questionnaires Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire and the International Consultation on Incontinence Questionnaire-Short Form. All data were processed and statistical analyses performed in statistical environment R, version 2.5.1.Results
From our results we conclude that there were no perioperative complications, objectively 62% of these patients were completely dry and 25% of patients improved. We observed a higher proportion of vaginal wall erosion (7/85) and urgency de novo (5/85) in the learning period group with respect to the routine period group.Conclusions
Our first experience with the tension-free vaginal tape secur system procedure is that it has a low percentage of perioperative complications. The learning curve has to be taken in account with reference to postoperative complications. 相似文献3.
Alois Martan Kamil Svabík Jaromir Masata Tomas Koleska Rachid El-Haddad Marketa Pavlikova 《International urogynecology journal》2009,20(5):533-539
Introduction and hypothesis The hypotheses of this study were that the TVT-SECUR procedure restricts urethral mobility, which leads to a greater likelihood
of curative effect, and that the restriction might change over time.
Methods Analyses of the position of the urethra and the tape of 85 patients who underwent the TVT-S procedure were performed using
perineal ultrasonography. The efficacy of the TVT-S procedure was evaluated by cough test and by the questionnaire ICIQ-UI
SF.
Results Objectively, 53/85 (62%) of patients had a negative cough test, and in 32/85 (38%) of patients leakage of urine persisted.
The TVT-S procedure restricts urethral mobility, and a higher degree of obstruction is associated with a higher likelihood
of cure. The restriction weakens within the first 3 months after surgery.
Conclusions The objective cure rate of TVT-S procedure is low irrespective of placement technique. This may be due to insufficient restriction
of urethral mobility. 相似文献
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