Abstract
Objective To investigate the short and long term effects of vaginal antetheca submucosal-retropubic space with mesh-repair through the implantation of biological patch (shortly as new-style vaginal mesh repair) in the treatment of the female patients with stress urinary incontinence (SUI). Methods From January 2009 to December 2014, 316 female patients diagnosed as SUI and with the treatment of new-style vaginal mesh repair in Jinan Military General Hospital, were chosen as study subjects, and were followed up more than 12 months. The special designed Chinese utility model patent named YGP-Ⅱ type of composite clamp for anterior vaginal wall acupoint patch separation and patch placement was used in this technique in this research. The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) was used for subjective evaluation of curative effects, and the urine pad test was used for objective evaluation. The clinical data of surgery condition and postoperative complications of these patients, and short and long term curative effects of this operation were statistically analyzed. The operation and research procedures were approved by the Ethics Committee of Jinan Military General Hospital, and obtained the informed consent of each patient. Results ①There were 264 cases of moderate SUI and 52 cases of severe SUI in this study. The average operation time was (15.7±4.2) min, the average intraoperative bleeding volume was (69.1±26.9) mL, and the average stay of hospitalization was (1.9±1.7) d. ②Postoperative complications included sensation of not emptying bladder completely finished urinating, fever, dysuria, urinary tract infection and exposure of the patch, and no serious complications were found. ③In female patients with moderate or severe SUI, preoperative ICIQ-SF scores were higher than that of 12 months after surgery, and the differences were statistically significant (t=12.569, 14.028; P<0.001). There was no significant difference of SUI recovery rate between patients with 12 months of follow-up and patients with more than 24 months of follow-up (91.8% vs 94.2%, χ2=1.020, P=0.211). Conclusions This new-style vaginal mesh repair in the treatment of moderate and severe SUI female patients is effective, the long term efficacy is reliable, and more minimally invasive. More multi-center, large sample randomized controlled trials need to be done and confirmed to decide whether it is suitable for clinical application. Key words: Urinary incontinence, stress; Treatment outcome; Vaginal antetheca submucosal-retropubic space with mesh-repair; Women
Published Version
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