Neurourology and urodynamics · 2020
Outcomes of Macroplastique injections for stress urinary incontinence after suburethral sling removal.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rodríguez Dayron, Carroll Timothy, Alhalabi Feras, Carmel Maude, Zimmern Philippe E
Аннотация
INTRODUCTION: To evaluate outcomes following urethral Macroplastique (MPQ) injection in women with stress urinary incontinence (SUI) following suburethral sling removal (SSR) for synthetic sling complications.
METHODS: Following Institutional Review Board approval, charts of non-neurogenic women with SUI after SSR who underwent MPQ injection(s) and had at least 6 months minimum follow-up were reviewed from a prospectively maintained database. Demographic data, questionnaire (Urogenital Distress Inventory-6 [UDI-6] and Quality of Life) scores, and pad usage were recorded. Patients were followed with repeat questionnaires and three-dimensional ultrasound evaluating MPQ volume. Success following MPQ was defined as a composite score of a UDI-6 question 3 score of 0 to 1 at last visit and no additional anti-incontinence therapy.
RESULTS: From 2011 to 2018, 70 women with mean age 62.7 years met study criteria. At a mean follow-up of 46.4 ± 1.5 months, the success rate after the first MPQ injection was 46%. Following a repeat MPQ injection when indicated, the overall success rate for the entire cohort was 69%. Despite the objective failure, the majority of patients reported subjective improvement (83%) and reduced pad usage (78%). On multivariate analysis: age, body mass index, previous hysterectomy, hormone replacement therapy, type of sling removed and baseline urodynamics (UDS) parameters were not predictors of MPQ failure. Higher parity was a predictor of MPQ failure (hazard ratio = 1.980; P = .032).
CONCLUSION: MPQ injection is a durable and effective management option for SUI following SSR, although a second injection may be required to achieve the desired success.
METHODS: Following Institutional Review Board approval, charts of non-neurogenic women with SUI after SSR who underwent MPQ injection(s) and had at least 6 months minimum follow-up were reviewed from a prospectively maintained database. Demographic data, questionnaire (Urogenital Distress Inventory-6 [UDI-6] and Quality of Life) scores, and pad usage were recorded. Patients were followed with repeat questionnaires and three-dimensional ultrasound evaluating MPQ volume. Success following MPQ was defined as a composite score of a UDI-6 question 3 score of 0 to 1 at last visit and no additional anti-incontinence therapy.
RESULTS: From 2011 to 2018, 70 women with mean age 62.7 years met study criteria. At a mean follow-up of 46.4 ± 1.5 months, the success rate after the first MPQ injection was 46%. Following a repeat MPQ injection when indicated, the overall success rate for the entire cohort was 69%. Despite the objective failure, the majority of patients reported subjective improvement (83%) and reduced pad usage (78%). On multivariate analysis: age, body mass index, previous hysterectomy, hormone replacement therapy, type of sling removed and baseline urodynamics (UDS) parameters were not predictors of MPQ failure. Higher parity was a predictor of MPQ failure (hazard ratio = 1.980; P = .032).
CONCLUSION: MPQ injection is a durable and effective management option for SUI following SSR, although a second injection may be required to achieve the desired success.