盆底网片重建术与压力性尿失禁相关性的研究

Study of correlation between stress urinary incontinence and pelvic mesh reconstruction

目的探讨盆底网片重建手术与压力性尿失禁的相关性。方法回顾性分析2012年1月至2013年1月因盆腔脱垂在我院妇产科行盆底网片重建手术的123例患者手术前后SUI发生情况。结果 123例患者术后6月均获随访,其中术后因SUI症状严重要求手术治疗患者2人,其中一例术前无SUI症状,一例术前有SUI症状,两名患者术中均未行TVT-O术。术前无SUI的患者中且未同时行TVT-O术49例,其中术后发生SUI者13例(26.5%),4例术中行TVT-O术,术后无一人发生SUI。术前有SUI但未行TVT-O术的患者31例,术后仍然存在SUI6例(19.4%),同时行TVT-O术的患者39例术后仍然存在SUI1例(2.6%)。结论盆底网片重建术中同时行TVT-O手术,能缓解术后SUI症状,减少术后SUI发生率;如盆腔脱垂合并压力性尿失禁,单纯行盆底网片术能使尿失禁症状缓解甚至消失,但对于术前无SUI患者一般不预防性行抗尿失禁手术。

Objective To investigate the correlation between pelvic mesh reconstructive surgery and stress urinary incontinence. Methods This is a retrospective analysis on 123 patients who underwent pelvic mesh reconstructive surgery in obstetrics and gynecology department of our hospital from January 2012 to January 2013. Preoperative SUI assessment and postoperative SUI occurrence were registered. Results 123 patients were followed up for 6 months postoperatively. Two patients,including one with and another without preoperative SUI symptoms,required reoperation because of severe postoperative SUI. Both of them didn't undergo TVT-O surgery. 13 cases( 26. 5%) were suffered from postoperative SUI in 49 cases without preoperative SUI who didn't undergo simultaneously TVT-O surgery. None of 4 cases without preoperative SUI but undergone intraoperative TVT-O surgery had postoperative SUI. 31 cases with preoperative SUI didn' t undergo TVT-O surgery,6 cases( 19. 4%) persisted postoperative SUI. 39 cases with preoperative SUI underwent intraoperative TVT-O surgery,postoperative SUI existed in 1 case( 2. 6%). Conclusion The results of this study indicate that pelvic reconstruction surgery with simultaneously TVT-O surgery can release postoperative SUI symptoms and reduce the incidence of postoperative SUI. Pelvic mesh reconstruction surgery can alleviate incontinence symptoms or even the symptoms disappear in the case of pelvic prolapse with stress urinary incontinence. But for patients without preoperative SUI,we generally advocate not do advocate prophylactic anti-incontinence surgery.