1.Bibliometric analysis of Wuqinxi intervention studies
Liqun GUO ; Rui ZHANG ; Xiaoyu LI ; Yunyue TANG ; Runjie ZHANG ; Shujin YUE
Chinese Journal of Practical Nursing 2022;38(25):1991-1996
Objective:To comprehensively collect the clinical research evidence of Wuqinxi, and provide reference for the future clinical research.Methods:China National Knowledge Infrastructure (CNKI), WanFang Database, VIP, China Biology Medicine disc (CBM), PubMed, Embase, Cochrane Library, and Web of Science were searched. The retrieval time limit was from the establishment of each database to March 31, 2021. After screening and extracting, SPSS 22.0 was used to analyze the basic characteristics, sample size, control and intervention measures, outcomes.Results:Totally 230 studies were included, of which 58.26% (134/230) were randomized controlled trial. The top 6 diseases were chronic obstructive pulmonary disease, osteoporosis, cervical pain, low back pain, diabetes and knee osteoarthritis. Common outcome included four items of blood lipid tests, blood glucose, immunological indicators and the evaluation of disease-related symptoms, such as pain, sleep and range of motion. The median frequency of Wuqinxi was once a day, 45 minutes each time, 5 days a week and lasted for 3 months. 94.78% (218/230) of the studies reported positive results. The safety and compliance of Wuqinxi intervention were good.Conclusions:The number of clinical studies on Wuqinxi is significantly less than Baduanjin and Taijiquan. It is necessary to formulate the report specification of intervention measures for Wuqinxi, so as to report the intervention plan of Wuqinxi more clearly and transparently.
2.Clinical observation of adjusting middle urethral sling tension through anatomic position during RMUS
Jiayi LI ; Qixiang SONG ; Weilin FANG ; Yiyuan GU ; Yunyue GUO ; Wei ZHANG ; Lei XU ; Wei XUE
Chinese Journal of Urology 2022;43(9):675-680
Objective:To investigate the safety and effectiveness of tension adjustment technique using anatomical landmarks during retropubic midurethral synthetic sling.Methods:The data of 36 consecutive female patients with urinary incontinence, who had underwent retropubic midurethral synthetic sling procedure from January to August 2019 were analyzed retrospectively. The mean age was (60.83±7.93) years old and the body mass index was (24.43±2.44) kg/m 2. Among the recruited subjects, 36 had positive stress test and Marshall-Marchetti test. 20 (55.6%) were pure stress urinary incontinence, and 16 (44.4%) were mixed urinary incontinence. The severity of incontinence was classified into mild (5 cases, 13.9%), moderate (14 cases, 38.9%), severe (13 cases, 36.1%) and very severe (4 cases, 11.1%) using one-hour pad tests. Urodynamics were performed in 17 cases, with 5 (29.4%) presented detrusor overactivity, 3 (17.7%) possessed intrinsic sphincter deficiency. For each case, the tension of the sling was adjusted based on the anatomical landmarks, i. e. using an angled clamp attached closely to the pubic symphysis ventrally and the tip parallel to the edge of hymen dorsally. All patients were catheter-free right after the procedure. The subjective and objective effectiveness, and safety (the rate of urinary retension after surgery and postvoid residual volume 3 months later) were evaluated.The subjective cure rate was was defined as complete leakage free or very mild leakage during excessive bladder filling and fierce cough. The subjective effectiveness was defined as over 50% improvement of the leakage symptom. The objective cure rate was defined as a negative stress test. Results:For all 36 patients, the median hospital stays was 8 (5-95)h. No bladder perforation or transfusion cases. All patients were catheter-free right after the procedure, with no incidence of urinary retention. 27 patients completed a 3-month follow-up, with 22 had post-void residual data, 23 had subjective effectiveness data and 23 had objective effectiveness data. The median post-void residual was 7.5 (5-64) ml, subjective cure rate was 91.3% (21/23), and objective cure rate was 95.7% (22/23). 8.7% (2/23) reported difficult urination alleviated without the necessity of clinical interference. No urethra erosion or vagina extrusion was found. At 2-year follow-up, 34 patients completed assessment by phone. The subjective cure rate was 91.2% (31/34), with only 2.9% (1/34) reported difficult urination. Besides, at 3-month follow-up, there was no difference regarding the subjective cure rate [100.0%(12/12) vs. 81.8%(9/11)]or objective cure rate [91.7%(11/12) vs. 100.0%(11/11)] between patients with stress and mixed incontinence. No difference was noted among patients with mild, moderate, severe and very severe leakage[75.0% (3/4) vs. 100.0%(6/6) vs. 90.0%(9/10) vs. 100.0%(3/3)]. Of the 12 cases with urodynamic records, the presence of detrusor overactivity [66.7%(2/3) vs. 88.9%(8/9)] or intrinsic sphincter deficiency [0(0/1) vs. 90.9%(10/11)] did not significantly affected the cure rate of the procedure. At 2-year follow-up, there was no difference regarding the subjective cure rate between patients with stress and mixed incontinence [94.7%(18/19) vs. 86.7%(13/15)]. No difference was also noted among patients with mild, moderate, severe and very severe leakage[80.0%(4/5) vs. 100.0%(13/13) vs. 83.3%(10/12) vs. 100.0%(4/4)]. Of the 16 cases with urodynamic records, the presence of detrusor overactivity [60.0%(3/5) vs. 90.9%(10/11)]or intrinsic sphincter deficiency [66.7%(2/3) vs. 84.6%(11/13)]did not significantly affected the cure rate of the procedure.Conclusions:Tension adjustment using anatomic landmarks during sling procedure is safe and feasible for urinary incontinence, with minimum complications and residual volume, and high subjective/objective cure rate.
3.Mixed urinary incontinence: will urgency and urge urinary incontinence symptoms resolve after RMUS?
Jiayi LI ; Wenxin XU ; Qixiang SONG ; Lei XU ; Yiyuan GU ; Yunyue GUO ; Jieying WANG ; Wei XUE
Journal of Modern Urology 2024;29(8):713-718
【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.