ABSTRACT
ObjectiveTo evaluate the short-term effectiveness of tension-free vaginal tapeobturator system(TVT-O) on the type Ⅰ,Ⅱ stress urinary incontinence(SUI) in the elderly female patients. Methods Elderly female patients (73 cases) with SUI type Ⅰ and Ⅱ were selected in 0.5-3.0 years after TVT-O surgical treatment,and they reached the age over 60 years before TVT-O.Difference of daily life and lower urinary tract symptoms before and after surgery were compared by the incontinence impact questionnaire ( Ⅱ Q-7) and the urogenital distress inventory (UDI-6) through telephone survey.Results Totally 73 patients were followed up successfully,aged 60 to 72 years (mean 64.0±4.5).Preoperative patients' daily life quality such as making housework,activities,entertainment,go-out,social contact and emotion had obviously been affected with a score of 9 to 25 by their own scoring (mean 17.0±6.7).Lower urinary tract symptoms including urgency,frequent urination,movement,leakage of urine volume,odynuria and dysuria were from 8 to 21 (mean 14.0±4.7) scores.Mild urinary frequency was 8.2％ (6 cases).Urinal pad usage was in 71 cases (97.3％)After TVT-O,patients' symptoms improved by their own scoring.The Ⅱ Q-7 scores were ranging from 2 to 13 (mean 6.4±3.2),and lower urinary tract symptoms scores from 1 to 9 (mean 5.4±3.2).Mild urinary frequency after surgery was 1.4 ％ (1 case).The urinary incontinence in 39 cases completely disappeared (53.4 ％ ),urinal pad usage were in 34 cases (46.6 ％ ).18 cases (24.7 ％ ) had suprapubic area pain or discomfort postoperatively.Conclusions TVT-O is an ideal choice for type Ⅰ and Ⅱ SUI in elderly female patients.
ABSTRACT
Objective To evaluate the relationship between ultrasound-assayed detrusor thickness and bladder outlet obstruction (BOO) in old men with benign prostatic hyperplasia (BPH).Methods The 106 BPH patients underwent the urodynamic examination on which the diagnosis of BOO was dependent. The obstruction was defined as the Abrams-Griffiths nomogram (A-G index)≥40 and the grade of linear passive urethral resistance relation (LinPURR)≥Ⅱ . When bladder capacity reached 150 ml, the detrusor thickness was measured by abdominal ultrasound. Results Compared with unobstructed group, the maximum flow rate and average flow rate were both lower in obstructed group [(10.1±3.0) ml/s vs. (17.4±3.1) ml/s, (5.5±2.2) ml/s vs. (11.2±2.2) ml/s, t= 10.26and 11.03, both P＜0.01]. And the residual urine volume and maximum detrusor pressure were significantly higher in obstructed group than in unobstructed group [(47.6 ± 24.3) ml vs. (17.0 ±5.6) ml, (39.3±14.4) cm H2Ovs. (26.8±8.0) cm H2O, t=6.32 and 4.07, P＜0.01 or 0.05].Detrusor thickness was positively correlated with maximum detrusor pressure (r= 0.419, P＜0.01),but negatively correlated with maximum flow rate (r =- 0.749, P＜ 0.01 ), mean flow rate (r=-0.853, P＜0.01) and voided volume (r=-0.556, P＜0.01). There was significant difference in detrusor thickness between obstructed group and unobstructed group [(3.0± 0.2) mm vs. (2.5 ±0.2) mm, t= 11.2,P＜0.05]. According to the diagnostic standard of detrusor thickness≥3.0 mm,it had a sensitivity of 90% and a specificity of 84.6%, a positive predictive value of 93.1% and a negative predictive value of 78.6%. Conclusions Detrusor thickness of 3.0 mm or greater has a certain predictive value for BOO in old men.