Long-Term Outcome of Raz Bladder Neck Suspension in Patients with Stress Urinary Incontinence

以內視鏡肺胱頸懸吊術治療婦女應力性尿失禁的長期評估

蔡芳生(Fang-Sheng Tsai) ； 黃懷恩(Wai-Yan Wong) ； 余宏政(Hong-Jeng Yu) ； 陳淳(Jun Chen)

《臺灣泌尿科醫學會雜誌》 14卷2期 (2003/06) Pp. 57-64

摘要

OBJECTIVE: To assess the long-term effects of Raz bladder neck suspension on the continence rate, lower urinary tract symptoms, and quality of life in a cohort of female patients with stress urinary incontinence.
MATERIALS AND METHODS: The medical records of 52 consecutive patients who underwent Raz bladder neck suspension at our institution between January 1995 and May 1998 by a senior urologist were retrospectively reviewed. An attempt was also made to contact all patients by telephone to complete a survey questionnaire.
RESULTS: Forty-four (84.6%) patients completed the questionnaire survey, with a mean follow-up of 69 (range, 36-78) months. The efficacy of the operation was confirmed in the short term, with 40 (91%) patients regaining continence by 1-month follow-up. Complications were minor. There was a progressive reduction in the continence rate with time, and consequently only 20 (45.5%) patients remained continent at follow-up. Patients with severe preoperative urinary incontinence were more likely to have experienced recurrence (Fisher’s exact test p＜0.05). The operation also significantly improved urinary frequency. Of all patients, 59.1% were very satisfied or satisfied with the results, and 63.6% acknowledged that the operation had improved their quality of life.
CONCLUSIONS: The advantages of low invasiveness, surgical morbidity, and medical expenditures of the Raz bladder neck suspension are compromised by the substantial failure rate with time. Therefore, this procedure should only be performed in patients with mild stress urinary incontinence for whom medical costs are a matter of great concern.

關鍵字

應力性尿失禁 ； 內視鏡膀胱頸懸吊術 ； 生活品質

並列摘要

OBJECTIVE: To assess the long-term effects of Raz bladder neck suspension on the continence rate, lower urinary tract symptoms, and quality of life in a cohort of female patients with stress urinary incontinence.
MATERIALS AND METHODS: The medical records of 52 consecutive patients who underwent Raz bladder neck suspension at our institution between January 1995 and May 1998 by a senior urologist were retrospectively reviewed. An attempt was also made to contact all patients by telephone to complete a survey questionnaire.
RESULTS: Forty-four (84.6%) patients completed the questionnaire survey, with a mean follow-up of 69 (range, 36-78) months. The efficacy of the operation was confirmed in the short term, with 40 (91%) patients regaining continence by 1-month follow-up. Complications were minor. There was a progressive reduction in the continence rate with time, and consequently only 20 (45.5%) patients remained continent at follow-up. Patients with severe preoperative urinary incontinence were more likely to have experienced recurrence (Fisher’s exact test p＜0.05). The operation also significantly improved urinary frequency. Of all patients, 59.1% were very satisfied or satisfied with the results, and 63.6% acknowledged that the operation had improved their quality of life.
CONCLUSIONS: The advantages of low invasiveness, surgical morbidity, and medical expenditures of the Raz bladder neck suspension are compromised by the substantial failure rate with time. Therefore, this procedure should only be performed in patients with mild stress urinary incontinence for whom medical costs are a matter of great concern.

並列關鍵字

stress urinary incontinence ； bladder neck suspension ； quality of life