Bladder outlet and bladder function change after the mid-urethral suspension treatment / 中华泌尿外科杂志

ABSTRACT

Objective To study the changes of the symptoms and quality of life (QOL) in patients after the Transvaginal tape-obturator (TVT-O) treatment and weather would this treatment lead to bladder outlet obstruction (BOO) and bladder function change. Methods A total of 82 stress urinary incontinence (SUI) women who had underwent TVT-O were included, age from 39-82 years, 3-60 months after operation. All patients were divided into 5 groups by the time post-operation. The ICI-Q-SF scores were collected to study the change of the symptoms and QOL of each group perioperation. Qmax, PVR, bladder weight, wall thickness of each group were collected to study whether would TVT-O lead to BOO and bladder function change. Results Forty-five (55%) patients were cured and 33(40 %) improved after TVT-O. Total cure rate was 95 %. There was a significant improvement of average symptom and QOL in all of the 5 groups (3-month, 6-month, 1-year, 2-year, above-2-year) (P＜0. 05). Qmax changed from (32. 17±10.74), (25.64±6.05), (25.68±11.36), (25.70±10. 28), (25.29±15. 10)ml/s pre-operation to (28.30±15.21), (25.64±10. 48), (24. 49±7.96),(25.43±11.92), (25. 92± 10. 17)ml/s post-operation in 5 groups(P＞0. 05). PVR changed from (0.04±0.20), (0. 00±0.00), (0. 17±0. 39), (2.70±6.01), (1. 96±5.10)ml pre-operation to (1. 79±6.16), (0.00±0.00), (12. 50±29.89), (5.00±15. 54), (33. 70±92.10)ml post-operation in 5 groups(P＞0.05). The bladder weight changed from (43. 62±7.81), (41. 57±8. 63), (46.11±8.12), (42. 50±3. 85), (44. 52±4. 38)g pre-operation to (45. 62±5.32), (47.21±5. 47),(44.89±4. 65), (45. 14±4. 13), (46. 70±5.84)g post-operation, which differed significantly in 6-month, 2-year, above-2-year groups (P＜0. 05). The bladder wall thickness changed from (2.23±0.51), (2.22±0.47), (2.04±0.38), (2. 19±0. 43), (2. 19±0. 38)mm pre-operation to (2.25±0. 40), (2. 18±0.47), (2. 07±0.47), (2.22±0. 47), (2. 20±0. 44)mm post-operation(P＞0. 05).Conclusions TVT-O has a high cure rate for SUI and there was a significant improvement of average symptom and QOL of all patients after the treatment. But TVT-O may lead to BOO and bladder function change since bladder weight increases significantly in some patients.