Порівняння функціональних результатів і якості життя після хірургічного лікування стресового нетримання сечі в жінок

Abstract

Sling surgery is a modern and effective surgical treatment for stress urinary incontinence in women. However, there is insufficient data on the comparative analysis of long-term results and quality of life of patients after various options of such operations. Purpose - to compare the functional results and quality of life of women after two variants of sling operations for stress urinary incontinence. Materials and methods. 84 women with stress urinary incontinence were examined, who were divided into two groups. In the Group I, a plastic free synthetic loop (TVT) was performed, in the Group II - an operation using the transobturator location of the prolene loop (TVT-Obturator - TVT-О). Functional outcomes of treatment and quality of life were assessed 2 years after surgery using the ICIQ-SF questionnaire, the Patient General Impression of Improvement (PGI-I) scale, and the Patient Satisfaction Scale. An objective indicator was the absence of leakage of urine during a cough test. Results. Treatment effectiveness, according to objective criteria, was 87.9% and 67.9% 2 years after TVT and TVT-O surgery, respectively (p=0.045). When evaluating subjective indicators, no statistically significant differences between groups were found, however, according to the ICIQ-SF questionnaire, the frequency of improvement in the quality of life was reliably 1.3 times higher in the case of using the TVT technique (odds ratio 3.33; 95% confidence interval 1.14-9.78). The frequency of urinary incontinence recurrence did not depend on the method of sling operation (p>0.05). Data analysis was carried out using The Statistical Package for Social Sciences. Conclusions. When evaluating the results of treatment 2 years after the intervention, the effectiveness of TVT surgery, according to objective criteria, is statistically significantly higher than the effectiveness of TVT-O surgery, although the latter technique is associated with the absence of bladder etching. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.