Mixed urinary incontinence: will urgency and urge urinary incontinence symptoms resolve after RMUS?
10.3969/j.issn.1009-8291.2024.08.011
- VernacularTitle:RMUS术治疗混合性尿失禁中尿急症、急迫性尿失禁症状的疗效观察
- Author:
Jiayi LI
1
;
Wenxin XU
1
;
Qixiang SONG
1
;
Lei XU
1
;
Yiyuan GU
1
;
Yunyue GUO
2
;
Jieying WANG
2
;
Wei XUE
1
Author Information
1. Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
2. Clinical Research Center, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
- Publication Type:Journal Article
- Keywords:
mixed urinary incontinence;
midurethral sling;
lower urinary tract symptom;
urodynamics;
urgency symptoms;
stress urinary incontinence;
urge urinary incontinence
- From:
Journal of Modern Urology
2024;29(8):713-718
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the efficacy of retropubic midurethral synthetic sling (RMUS) in relieving urgency and urge urinary incontinence (UUI) symptoms in patients with mixed urinary incontinence (MUI). 【Methods】 Clinical data of 44 female MUI patients treated with RMUS during Jan.2018 and Dec.2020 in Shanghai Renji Hospital were retrospectively analyzed.All patients had positive results in stress test and Marshall-Marchetti test before operation, and 27 of them completed ICIQ-FLUTS-LF questionnaire.Urodynamic (UDS) tests suggested that 9 patients (20.5%) presented detrusor overactivity (DO).During RMUS procedure, the tension of the sling was adjusted based on the anatomical landmarks.The postoperative efficacy and improvement of urinary incontinence were analyzed. 【Results】 The patients aged (58.59±9.08) years, with a body mass index of 24.71±2.77.Among the 40 patients who completed telephone interview 2 years after surgery, the subjective cure rate was 85.0% (34/40).Among the 27 patients with records of questionnaires before and after surgery, there were significant differences in the incidence of urine leakage \[100% (27/27) vs. 18.5% (5/27)\], stress urinary incontinence (SUI) \[100% (27/27) vs. 18.5% (5/27)\] and UUI \[70.4% (19/27) vs. 29.6% (8/27)\] (P<0.05).However, no statistical differences were found regarding nocturia voiding episode (≥1 times), urgency, dysuria, hesitancy, strain to void, intermittent stream and enuresis (P>0.05).Based on preoperative UDS test, there were significant differences regarding the subjective cure rate in patients with or without preoperative DO \[55.6% (5/9) vs. 93.5% (29/31)\], incidence of SUI \[66.7%(4/6) vs. 4.8% (1/21)\], and UUI \[66.7% (4/6) vs. 19.0% (4/21)\] (P<0.05), while there was no statistical difference regarding urgency \[66.7% (4/6) vs. 33.3% (7/21)\] (P>0.05). 【Conclusion】 RMUS is effective in treating MUI patients with positive stress test and Marshall-Marchetti test results, which can relieve SUI and UUI symptoms, but has no effects on urgency symptoms.DO on preoperative urodynamics results in poorer subjective outcomes.
