TVT-O与TVT-S治疗女性压力性尿失禁的远期有效性及安全性

Long-term efficacy and safety of TVT-O and TVT-S in the treatment of female stress urinary incontinence

目的：比较经阴道、经闭孔无张力尿道中段悬吊术（TVT‐O）与单切口经阴道、经闭孔无张力尿道中段吊带术（TVT‐S）两种尿道中段悬吊术式治疗女性压力性尿失禁的远期有效性及安全性。方法回顾性分析2007年6月至2014年2月我院由同一手术医师进行操作的TVT‐O与TVT‐S两种尿道中段悬吊术式患者的临床资料。评估比较两种术式患者手术前后一般指标、术后患者客观、主观治愈率及术后腹股沟区疼痛、及其并发症发生情况。结果共45例患者入选研究，整体平均年龄（55．07±12．25）（31～86）岁，术后平均随访时间（43．2±24．0）（6～86）个月，两组患者术前资料、手术相关指标均无统计学差异（P＞0.05）。术后两组患者生活质量简表评分（ICIQ‐SF）相比无统计学差异（P＞0．05）；术后患者客观治愈率（TVT‐O组78．95％vs．TVT‐S组76．92％）、主观治愈率（TVT‐O组68．42％vs．TVT‐S组76．92％）、术后腹股沟区疼痛发生率（TVT‐O组21．05％vs．TVT‐S组3．85％）等指标与术前比较，均无显著性差异（P均＞0.05）。结论TVT‐O及TVT‐S两种术式均能有效治疗女性压力性尿失禁。TVT‐S吊带的远期疗效并不弱于TVT‐O吊带。

Objective To compare the clinical efficacy and safety of transobturator midurethral sling （TVT‐O） and sin‐gle‐incision sling TVT‐Scure （TVT‐S） in the treatment of female stress urinary incontinence （SUI） .Methods Clinical data of female SUI patients who underwent TVT‐O or TVT‐S procedure by one same doctor during Jun .2007 to Feb .2014 in our center were collected .The pre‐and peri‐operative data ,subjective cure rate ,objective cure rate ,groin pain and other complications were compared .Results A total of 45 patients were enrolled .The patients＇average age was （55 .07 ± 12 .25） （31-86） years .The mean follow‐up was （43 .2 ± 24 .0） （6-86） months .There were no sig‐nificant differences in pre‐operative data or peri‐operative data （P〉0 .05） between the two groups .No significant differences were found in post‐operative international consultation on incontinence‐short form （ICIQ‐SF） score （P〉0 .05） .The objective and subjective cure rate of TVT‐O group and TVT‐S group was 78 .95% vs .76 .92% （P=0 .872） ,and 68 .42% vs .76.92% （P=0 .524） .The incidence of groin pain rate of TVT‐O group and TVT‐S group was 21 .05% vs .3 .85% （P=0 .070） .Conclusion Both TVT‐O procedure and TVT‐S procedure are effective and reliable in treatment of female SUI .The long‐term follow‐up results showed that TVT‐S has nearly the same good results as TVT‐O .