Analysis Of The Clinical Efficacy Of Autologous Fascial Midurethral Suspension And Tension-free Vaginal Tape Obturator In The Treatment Of Female Stress Urinary Incontinence

Objective: To compare the clinical efficacy the use of autologous fascial midurethral suspension and the tension-free vaginal tape obturator(TVT-O)in the treatment of female stress urinary incontinence.Methods: Aretrospective analysis of patients in the Department of Urology of Suining Central Hospital who underwent mid-urethral sling from January 2016 to October 2020. According to the inclusion and exclusion criteria,47 patients were selected.According to the different surgical methods selected by the patients,the included patients were divided into autogenous fascia suspension group(15 cases)and TVT-O group(32 cases).Collect clinical data of autogenous fascia sling operation group and TVT-O group,including age,body mass index(BMI),pregnancy times,delivery times and methods,preoperative urine flow rate,and preoperative residual urine in the bladder Volume,operation time,postoperative indwelling catheter time,postoperative hospital stay,intraoperative complications,postoperative complications,postoperative urine flow rate,postoperative residual urine volume of the bladder.Before surgery,a questionnaire survey was used to collect the International Consultation on Incontinence Questionnaire-short form(ICI-Q-SF)and Incontinence quality of life questionnaires(I-QOL)information.After the operation,telephone follow-up was used to complete the I-QOl and the patient global impression of improvement(PGI-I) questionnaire.According to the outpatient review,the urine flow rate and bladder residual urine of all patients were collected one month after the operation.The data collected were analyzed using SPSS 21.0 statistical software,and statistical differences were considered at P<0.05.Results: The average age of the autogenous fascia suspension group was(48.6±3.3)years,the average BMI was(24.6±0.8)kg/m2,the average number of pregnancies was(2.5±1.0),and the average number of deliveries was(1.9±0.5);In the TVT-O group,the average age was(50.3±9.2)years,the average BMI was(24.9±3.4)kg/m2,the average number of pregnancies was(3.3±1.8),and the average number of deliveries was(2.3±1.2).There was no significant difference Statistically significant(P>0.05),the data of the two groups are comparable.In the autogenous fascia suspension group,the preoperative average urine flow rate was(30.21± 11.12)m L/s,and the postoperative average urine flow rate was(24.62±12.51)m L/s,the difference was not statistically significant(P=0.089).There was no statistically significant difference in intraoperative bleeding,and time to remove the urinary catheter after surgery between the two groups(P>0.05).The mean operative time was(102±5.4)min in the autologous fascial suspension group and(46.8±6.5)min in the TVT-O group,with statistically significant differences(P<0.05).There was 1 case(6.7%)of postoperative urinary retention in the autofascial suspension group and 4 cases(12.5%)of postoperative urinary retention in the TVT-O group,with no statistically significant difference(P>0.05).the mean postoperative hospitalization days were 6.5 ± 1.7 days in the autofascial suspension group and 4.3±2.8 days in the TVT-O group,with no statistically significant difference(P<0.05). Using the PGI-I at the one-month postoperative follow-up as an index to evaluate the objective cure rate of patients,15 cases(100%)improved after surgery in the autologous fascia group,28 cases(87.5%)improved after surgery in the TVT-O group,and 4 cases(12.5%)did not improve significantly.According to the one-month postoperative follow-up,no infection or pain complications occurred in the autologous fascial suspension group.17 cases(53.1%)in the TVT-O group had thigh root pain,2 cases(6.25%)had lower urinary tract infection,and 2 cases(6.25%)had needle tract infection.According to the three-month postoperative follow-up,the I-QOl score of the autologous fascial suspension group was 100±2.10,and the I-QOL score of the TVT-O group was 95.37±15.87,with no statistically significant difference(P>0.05).Conclusion: The autogenous fascia sling has obvious short-term curative effect in the treatment of SUI,which is similar to the artificial material sling TVT-O in subjective and objective cure rates.Both operations are suitable for the treatment of female SUI,and the treatment effect is obvious.Autogenous fascia sling has the advantages of postoperative urinary tract infection and lower incidence of postoperative pain in the inner thigh.The artificial material sling TVT-O has the advantages of short operation time,less intraoperative blood loss,and short postoperative hospital stay.