Clinical effect of TOT on female patients with stress urinary incontinence and urinary meatus stricture
Objective To investigate the urodynamic characteristics of female stress urinary incontinence with urinary meatus stricture(UMS)and the clinical effect of trans-obturator vaginal tape(TOT)surgery.Methods The urodynamic examination and clinical data of 52 female patients with SUI who underwent TOT surgery in the hospital from January 2018 to December 2021 were retrospec-tively analyzed.The patients were divided into two groups:SUI with UMS(UMS group,14 cases)and SUI without UMS(WUMS group,38 cases).The urodynamic results of the two groups were compared and analyzed.Before and 2 weeks after TOT operation,the effect of TOT operation on SUI patients in UMS and WUMS groups was evaluated.Results There were no significant difference between the two groups in the incidence of clinical symptoms,such as frequency of urination,urgency,laborious urina-tion and urinary tract infection(all P＞0.05).The maximum urine flow rate(Qmax)and average urine flow rate(Qave)in UMS group were significantly lower than that in WUMS group before operation,and the differences were statistically significant(all P＜0.05).The peaking time of urination in UMS group was significantly lower than that in WUMS group,and the TQmax/VT ratio was significantly lower than that in WUMS group,with statistical significance(all P＜0.05).The pressure of detrusor at maximum quantity of urine of patients in UMS group was significantly higher than that in WUMS group,and the Qmax in UMS group was significantly lower than that in WUMS group,and the differences were statistically significant(all P＜0.001).The Qmax of patients in the two groups did not decrease signifi-cantly before and 2 weeks after operation,and the difference was not statistically significant(all P＞0.05).The ICI-Q-SF scores of both groups were significantly decreased 2 weeks after surgery compared with those before surgery,with statistical significance(all P＜0.05).There was no significant differ-ence in ICI-Q-SF scores before and 2 weeks after surgery between the two groups(all P＞0.05).Con-clusions The Qmax of SUI patients with urethral meatus stricture is significantly lower than that of SUI patients without urethral meatus sticture,but urethral meatus stricture is not a contraindication of TOT surgery.Its surgical effect is good and does not increase the risk of postoperative urinary retention or dysuria.
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