Sequential combined approach in patients with mixed urinary incontinence: surgery followed by posterior tibial nerve stimulation.

Autor:	Carletti V; Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy - valeriocarletti10@gmail.com., Yacoub V; Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy., Grilli D; Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy.; Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy., Morgani C; Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy.; Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy., Palazzetti PL; Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy., Zullo MA; Department of Surgery-Week Surgery, Campus Bio-Medico University, Rome, Italy., Luffarelli P; Department of Surgery-Week Surgery, Campus Bio-Medico University, Rome, Italy., Valensise HC; Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy.; Department of Obstetrics and Gynecology, Casilino Hospital, Rome, Italy., Maneschi F; Department of Obstetrics and Gynecology, San Giovanni Addolorata Hospital, Rome, Italy., Spina V; Maternal and Child Department, San Camillo de Lellis Hospital, Rieti, Italy., Schiavi MC; Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Minerva obstetrics and gynecology [Minerva Obstet Gynecol] 2024 Feb; Vol. 76 (1), pp. 7-13. Date of Electronic Publication: 2022 Jul 04.
DOI:	10.23736/S2724-606X.22.05106-5
Abstrakt:	Background: The aim of the study was to demonstrate the efficacy of sequential combined treatment with transobturator tape (TOT) followed by posterior tibial nerve stimulation (PTNS) in patients with mixed urinary incontinence (MUI); quality of life and patients' satisfaction was also assessed. Methods: Retrospective analysis on women affected by MUI with prevalent Stress Urinary Incontinence (SUI) component. Women, divided in 2 groups, underwent different treatments, TOT vs. TOT+PTNS. Population was assessed by medical history, previous pelvic surgery, clinical exam, urodynamic exams, pelvic ultrasound examination, and questionnaires (The International Consultation on Incontinence Questionnaire Short Form, Overactive Bladder Questionnaire, Health Related Quality of Life) comparing them before and after 12 weeks after treatment. Results: One hundred twelve women were enrolled in the study. The mean age was 57.96±7.34 in the first group (N.=60) and 58.29±6.14 in the second group (N.=52). Peak flow (mL/s) statistically improved after treatment, 22.23±4.29 (TOT) vs. 24.81±5.8 (TOT+PTNS). First voiding desire (mL) improved significantly between the two groups 108.72±19.24 vs. 142.43±19.98. Maximum cystometric capacity (mL) in the TOT group at 12-weeks was 328.76±82.44 vs. TOT+PTNS group of 396.26±91.21. Detrusor pressure at peak flow(cmH2O) showed a greater improvement in TOT+PTNS than TOT alone 14.45±6.10 vs. 11.89±54.49. At 12-week, urinary diary and quality of life improved in terms of urgent urination events, mean number of voids, urge symptoms and nocturia events. The Patient Impression of Global Improvement (PGI-I) after 3 months was better in combined group. Conclusions: Combined and sequential TOT+PTNS is more effective compared to TOT alone in MUI patients with prevalent SUI component.
Databáze:	MEDLINE
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