Patient Satisfaction After Sling Revision for Voiding Dysfunction After Sling Placement
Patient Satisfaction After Sling Revision for Voiding Dysfunction After Sling Placement
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DOI：
10.1097/spv.0000000000000242
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发表时间：
2016-05-01
影响因子：
1.6
通讯作者：
Trabuco, Emanuel C.
中科院分区：
文献类型：
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作者：
Kim-Fine, Shunaha;El-Nashar, Sherif A.;Trabuco, Emanuel C.
目的：本研究的目的是评估女性压力性尿失禁吊带手术后解除吊带排尿的患者报告的结果。方法：从2000年1月1日至2008年10月31日，明尼苏达州罗彻斯特市梅奥诊所（Mayo Clinic）所有因排尿障碍而解除吊带的女性患者都被确定并邮寄了一份调查问卷，其中包括排尿症状的有效问题。选择手术成功的综合结果，其中参与者报告整体改善（至少“好得多”）和7分李克特量表的完全满意度。Logistic回归分析用于确定该结果的临床和手术预测因素。结果：总共确定了101名女性，其中98名在邮寄时还活着，55名女性（56.1%）回应了调查。在解除吊带前，62例患者使用了合成中段吊带，39例患者使用了生物吊带。除了从翻修手术到调查的时间外，邮件应答者和无应答者的临床特征相似（中位数，38.8个月vs 54.6个月；P = 0.05）。总体而言，55名应答患者中有23名（41.8%）达到了手术成功的预定标准。多变量分析发现，年龄小于60岁（比值比[OR]， 4.22; P = 0.02）、解除吊带前是否有膀胱过度活动症状（比值比[OR]， 3.99; P = 0.04）、解除吊带的类型（吊带切开或松动vs部分或完全切除）（比值比，3.78;P = 0.05）是成功的预测因素。结论：在应答者中，23人（41.8%）报告了整体改善和满意度。年龄较小、解除吊带前没有膀胱过度活动症状的记录、吊带切开或松动而不是部分或完全切除进行吊带解除与患者满意度和患者报告的改善相关。
Objective: The aim of this study was to evaluate patient-reported outcomes after sling release for obstructive voiding after sling operation for female stress urinary incontinence.Methods: All female patients who had sling release for obstructive voiding at Mayo Clinic in Rochester, Minnesota, from January 1, 2000, through October 31, 2008, were identified and mailed a survey including validated questions for voiding symptoms. A composite outcome for surgical success was chosen in which participants reported global improvement (at least "much better") and complete satisfaction on a 7-point Likert scale. Logistic regression analysis was used to identify clinical and surgical predictors of this outcome.Results: In total, 101 women were identified, of which 98 were alive at the time of mailing, and 55 women (56.1%) responded to the survey. Surgery before sling release was a synthetic midurethal sling in 62 patients and biologic sling in 39 patients. Clinical characteristics among mailing responders and nonresponders were similar aside from time from revision surgery to survey (median, 38.8 vs 54.6 months; P = 0.05). Overall, 23 (41.8%) of the 55 responding patients met the predefined criteria for surgical success. Multivariable analysis identified age younger than 60 years (odds ratio [OR], 4.22; P = 0.02), absence of overactive bladder symptoms before sling release (OR, 3.99; P = 0.04), and type of sling release (sling incision or loosening vs partial or complete excision) (OR, 3.78; P = 0.05) as predictors of success.Conclusions: Of responders, 23 (41.8%) reported global improvement and satisfaction. Younger age, lack of documented overactive bladder symptoms before sling release, and performing sling release with sling incision or loosening rather than partial or complete excision were associated with better satisfaction and patient-reported improvement.