Trends in surgical management and pre-operative urodynamics in female medicare beneficiaries with mixed incontinence.
Trends in surgical management and pre-operative urodynamics in female medicare beneficiaries with mixed incontinence.
复制标题
混合性尿失禁女性医疗受益人的手术管理和术前尿动力学趋势。
DOI：
10.1002/nau.22946
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发表时间：
2017
影响因子：
2
通讯作者：
Sedrakyan,Art
中科院分区：
文献类型：
--
作者：
Chughtai,Bilal;Hauser,Nicholas;Anger,Jennifer;Asfaw,Tirsit;Laor,Leanna;Mao,Jialin;Lee,Richard;Te,Alexis;Kaplan,Steven;Sedrakyan,Art
我们试图检查手术的趋势和利用的治疗混合性尿失禁的女性医疗保险beneficiaries.MethodsData是从2000年至2011年的门诊病人和承运人索赔的5%的国家随机样本。纳入了65岁及以上女性患者，诊断为混合性尿失禁，接受了现行手术术语第四版（CPT-4）代码确定的手术治疗。还使用CPT-4代码识别了初次和二次手术前的尿动力学（UDS）。手术趋势和UDS的利用率进行了analysed. ResultsUDS的利用率增加在研究期间，从38.4%到74.0%之前，最初的手术干预，从28.6%到62.5%之前再干预。吊带手术（63.0%）和注射填充剂（28.0%）是最常见的手术治疗方法，其次是骶神经刺激（SNS）（4.8%）和Burch（4.0%）手术。4.0%最初接受悬吊术治疗的患者和21.3%接受填充剂治疗的患者进行了再干预，其中大多数（分别为51.7%和76.3%）接受了填充剂注射。在初次手术前接受或未接受尿动力学检查的患者中，再次介入的风险无差异（8.5% vs. 9.3%）。结论吊带和散装药物是MUI最常见的治疗方法。术前尿动力学检查与该人群混合性尿失禁手术后再次干预的风险无关。Urodynam。36：422-425，2017.© 2015 Wiley Periodicals，Inc.
ObjectiveWe sought to examine the surgical trends and utilization of treatment for mixed urinary incontinence among female Medicare beneficiaries.MethodsData was obtained from a 5% national random sample of outpatient and carrier claims from 2000 to 2011. Included were female patients 65 and older, diagnosed with mixed urinary incontinence, who underwent surgical treatment identified by Current Procedural Terminology, Fourth Edition (CPT‐4) codes. Urodynamics (UDS) before initial and secondary procedure were also identified using CPT‐4 codes. Procedural trends and utilization of UDS were analyzed.ResultsUtilization of UDS increased during the study period, from 38.4% to 74.0% prior to initial surgical intervention, and from 28.6% to 62.5% preceding re‐intervention. Sling surgery (63.0%) and injectable bulking agents (28.0%) were the most common surgical treatments adopted, followed by sacral nerve stimulation (SNS) (4.8%) and Burch (4.0%) procedures. Re‐intervention was performed in 4.0% of patients initially treated with sling procedures and 21.3% of patients treated with bulking agents, the majority of whom (51.7% and 76.3%, respectively) underwent injection of a bulking agent. Risk of re‐intervention was not different among those who did or did not receive urodynamic tests prior to the initial procedure (8.5% vs. 9.3%)ConclusionsSling and bulk agents are the most common treatment for MUI. Preoperative urodynamic testing was not related to risk of re‐intervention following surgery for mixed urinary incontinence in this cohort.Neurourol. Urodynam. 36:422–425, 2017. © 2015 Wiley Periodicals, Inc.