Minimally Invasive Treatment of Stress Urinary Incontinence in Women: A Prospective Comparative Analysis between Bulking Agent and Single-Incision Sling.

Autor:	Campanella L; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; Department of Obstetrics and Gynaecology, Università di Tor Vergata, 00133 Rome, Italy., Gabrielli G; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; Department of Obstetrics and Gynaecology, Università di Tor Vergata, 00133 Rome, Italy., Chiodo E; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; Department of Obstetrics and Gynaecology, Università di Tor Vergata, 00133 Rome, Italy., Stefanachi V; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; Department of Obstetrics and Gynaecology, Università di Tor Vergata, 00133 Rome, Italy., Pennacchini E; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; Department of Obstetrics and Gynaecology, Università di Tor Vergata, 00133 Rome, Italy., Grilli D; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; Department of Obstetrics and Gynaecology, Università di Tor Vergata, 00133 Rome, Italy., Grossi G; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy., Cignini P; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy., Morciano A; Department of Obstetrics and Gynaecology, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy.; AIUG Research Groups, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Rome, Italy., Zullo MA; AIUG Research Groups, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Rome, Italy.; Department of Week-Surgery, Policlinico Universitario Campus Bio Medico, 00128 Rome, Italy., Palazzetti P; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy., Rappa C; AIUG Research Groups, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Rome, Italy.; Andrea Grimaldi Medical Care, 80122 Naples, Italy., Calcagno M; Department of Obstetrics and Gynecology, Santo Spirito Hospital, 00193 Rome, Italy., Spina V; Maternal and Child Department, S. Camillo de Lellis Hospital, 02100 Rieti, Italy., Cervigni M; AIUG Research Groups, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Rome, Italy.; Department of Female Pelvic Medicine and Reconstructive Surgery, Istituto Marco Pasquali ICOT, 04100 Latina, Italy., Schiavi MC; Department of Obstetrics and Gynaecology, Ospedale Sandro Pertini, 00157 Rome, Italy.; AIUG Research Groups, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Rome, Italy.
Jazyk:	angličtina
Zdroj:	Healthcare (Basel, Switzerland) [Healthcare (Basel)] 2024 Mar 29; Vol. 12 (7). Date of Electronic Publication: 2024 Mar 29.
DOI:	10.3390/healthcare12070751
Abstrakt:	Introduction: The study aims to compare the efficacy and safety of bulking agents and single-incision slings in the treatment of urinary incontinence in 159 patients during a 29-month follow-up period. Material and Methods: Of the 159 patients suffering from stress urinary incontinence, 64 were treated with bulking agents (PAHG Bulkamid ® ) and 75 with a single-incision sling (Altis ® ). The ICIQ-UI-SF (Incontinence Questionnaire-Urine Incontinence-Short Form), PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaires short form), FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Scale), and PGI-I (Patient Global Improvement Index) were used to assess efficiency and quality of life. Results: The bulking agents showed high efficacy and safety during the 29-month follow-up. Post-operative complications were recorded in both groups, with only two significant differences. The Bulkamid group experienced no pain, while 10.8% of the ALTIS group experienced groin pain and 5% experienced de novo urgency. Furthermore, patients treated with bulking agents experienced reduced nicturia (0.78 vs. 0.92 in patients treated with single-incision slings.). In both groups, we noticed a significant improvement in QoL (quality of life), with a halved ICIQ-UI-SF (International Consultation on Incontinence Questionnaire-Urine Incontinence-Short Form) score which was completed to assess the impact of urine symptoms. After 24 months of therapy, the Bulkamid group saw a decrease from 14.58 ± 5.11 at baseline to 5.67 ± 1.90 ( p < 0.0001), whereas the ALTIS group experience a decrease from 13.75 ± 5.89 to 5.83 ± 1.78. Similarly, we observed an improvement in sexual function, with the number of sexually active patients increasing from 29 to 44 (56.4%) in the Bulkamid group ( p = 0.041) and from 31 to 51 (61.7%) in the ALTIS group ( p = 0.034). According to the most recent statistics, the PISQ-12, FSFI, and FSDS scores all demonstrated an improvement in women's sexual function. Conclusions: In terms of efficacy and safety, bulking agents had notable results over the 29-month follow-up period. Furthermore, the patients treated with bulking agents reported a lower incidence of postoperative complications and a no discernible difference in terms of quality of life and sexual activity compared to the ones treated with single-incision slings. Bulking agents can be considered a very reliable therapeutic option based on accurate patient selection.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu