Project title
經閉鎖孔尿道下束帶手術治療女性尿動力應力性尿失禁之手術前後的尿動力所見之連續性評估
Internal ID
NSC94-2314-B002-213
Principal Investigator
Start Date
August 1, 2005
End Date
July 12, 2006
Investigators
黃思誠
Organizations
Partner Organizations
Project Web Site
Sequential Assessment of Urodynamic Findings before and after Transobturator Suburethral Sling Procedure for Female Urodynamic Stress Incontinence = 經閉鎖孔尿道下束帶手術治療女性尿動力應力性尿失禁之手術前後的尿動力所見之連續性評估
Description
The tension-free vaginal tape (TVT) operation for female stress urinary incontinence (SUI) was first introduced by Ulmstem in 1995 [1-3]. Although more than 150 kinds of operation for treating SUI have been reported [4], TVT operation has now become one of the most common operation for SUI due to its easy procedure, high success rate and low complication rate [5-11]. Due to the progress of surgical skill, a new method which uses transobturator foramen to put a sling under mid-urethra called transobturator suburethral sling procedure (TOT operation or MONARC operation) was introduced in 2003 [12,13]. This TOT operation is more easy to perform and it has no need to use cystoscopy intraoperatively when compared to TVT operation. Besides, its operation time is shorter than TVT operation and both have the very similar success rate [13]. Although TVT operation for treating SUI cases has become the main stream in recent years, there are only several reports to discuss the possible mechanism of success by this operation in literature [14-17]. We have reported that the significantly increased stress urethral pressure profile parameters may contribute to the high cure rate of TVT operation in 2004 [17]. Thus, we plan to recruit over 30 female patients with urodynamic stress incontinence, which was called genuine stress incontinence (GSI) before in this prospective study [18]. A detailed history will be recorded for each patient prior to physical examination and multi-channel urodynamic study. These patients will complete urodynamic study and 20-minute pad test before TOT operation and at 3, 6 and 12 months after operation. The sequential urodynamic findings of each patient will be compared and analyzed. All terminology and procedures conform to the standards recommended by International Continence Society or Urodynamic Society [19]. The generalized linear estimation of repeated measurement with Bonferroni’s multiple comparison test will be used for statistical analysis [17]. We expect this prospective study will conclude: 1) The success rate of TOT operation by pad test; 2) whether the presence of complication and its percentage; and 3) the sequential changes of urodynamic parameters and their significance. This study is an original one and no such report in literature so far. Besides, it will bring great significance in clinical practice.