To compare the efficacy of autologous fascial retropubic midurethral sling, anterior vaginal wall epithelial flap midurethral suspension, tension-free vaginal tape-obturator and adjustable urethral suspension with a single incision for the treatment of female stress urinary incontinence.
A total of 243 SUI patients who were admitted to Minda Hospital of Hubei Minzu University, were chosen and split into four groups based on various surgical techniques: the AFS group (59 cases), TVT-O group (61 cases), epithelial flap group (62 cases) and ASIS group (61 cases). A comparison of four patient groups' quality-of-life scores, urodynamic indices, urethral structure-related indices before and a year after treatment, complication rates and perioperative-related indices.
There was no discernible difference in the treatment outcomes among the four groups(P>0.05). However, the ASIS group exhibited significantly reduced intraoperative hemorrhage, hospitalization duration and operative time compared to the mucosal flap and TVT-O groups(P<0.05). Both the TVT-O and ASIS groups demonstrated significantly higher hospitalization expenditures than the mucosal flap and AFS groups (P<0.05). No significant differences were observed in postoperative indwelling catheterization, IIQ-7 and I-QOL ratings, urodynamic indices or urethral structure-related indexes across the four patient groups(P>0.05). The TVT-O group showed a significantly higher incidence of postoperative medial thigh pain compared to the AFS, mucosal flap, and ASIS groups(P<0.05). Similarly, the AFS group had a significantly greater incidence of postoperative urine retention compared to the mucosal flap, TVT-O, and ASIS groups(P<0.05).
While all four surgical techniques demonstrated good efficacy and improved patients' quality of life, our study suggests that TVT-O had a significantly higher incidence of post-treatment medial thigh pain and ASIS may be a safer and less problematic surgical approach for the treatment of female SUI. This has important therapeutic implications.
International journal of women's health. 2024 Nov 29*** epublish ***
Zhuo Jiang, Chaoyan Yuan
Department of Medical School, Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People's Republic of China., Department of Gynecology, Minda Hospital of Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People's Republic of China.