单切口吊带术治疗女性压力性尿失禁中期疗效和安全性分析

Mid-term efficacy and safety analyzes of single incision mini sling system for female stress urinary incontinence

目的评估单切口吊带（SIMS）治疗女性压力性尿失禁（SUI）的中期疗效及安全性;复习相关文献,提高对SIMS手术的认识。方法回顾性分析2013年4～8月所完成16例随访超过12个月（12～17月）的SIMS-adjust手术患者：年龄49～72岁,平均年龄61.2岁,病程3～17年,平均5.3年,体重指数22.6～34.1kg/m2,平均26.3kg/m2,分娩1～6次,平均2.2次;SUI分型Ⅰ型3例,Ⅱ型8例,Ⅲ型5例;残余尿量最高30mL,平均少于10mL,3例患者合并阴道前壁轻度脱垂,无尿流梗阻表现。终点指标包括有效性、安全性及患者满意度等。结果 16例患者手术均顺利,生活质量获得改善,1年期评分较基线降低（5.2±2.1）cm,所有患者术中出血均少于50mL,2例于术后6月及8月发生轻度尿失禁,1例术后3月开始性生活出现疼痛,1例排尿困难,残余尿量300mL,1例术后新发尿急,1例阴道吊带外露,1例左侧腹股沟区域疼痛,所有并发症治疗后均恢复。结论 SIMS-Ajust？）是治疗女性SUI的有效方法,手术1年期临床效果可靠,安全性高,术后并发症如腹股沟区疼痛、排尿困难及新发尿急的发生率均较低。术后恢复正常活动和工作时间较短。

Objective To evaluate the mid-term efficacy and safety for adjustable single incision mini sling（SIMSAjust）treatment on female stress urinary incontinence（SUI）.Methods A total of 16 cases undergone SIMS-Ajust were followed up over 12 months（2 to 17 months）.The average age of patients was 61.2 years（49 to 72 years）.The course of disease ranged from 3 to 17 years（average 5.3 years）.The body mass index ranged from22.6 to 34.1 kg/m2（average 26.3 kg/m2）.The delivery ranged from 1 to 6 times（average 2.2 times）.SUI type I involved 3 cases,type II 8 cases and type Ⅲ 5 cases.The highest residual urine volume was 30 mL and averaged less than10 mL before operation.Altogether 3 cases had mild anterior vaginal wall prolapses,but none of them had urinary obstruction.The clinical data were retrospectively analyzed,including validity,security,patients＇satisfaction.Results All operations were successful.The quality of life（QOL）was improved and decreased by（5.2±2.1）cm compared with baseline data within one year.All patients bled less than 50 mL.Mild incontinence occurred in 2 cases 6-8 months after surgery.Pain in sex occurred in 1 case 3 months after operation.Dysuria developed in 1 case,with300 mL residual urine.Urgency occurred in1 case.Vaginal tape erosion occurred in 1 case.Left groin pain occurred in 1 case.All complications were cured.Conclusion SIMS-Ajust is an effective treatment for female SUI.The clinical results and safety are satisfactory in 1 year.The incidence of complications,such as groin pain,dysuria and neourgency,is low.Patients can soon return to normal activities and work.