TVT-O治疗女性压力性尿失禁前后患者自身症状和性生活质量的临床分析

Clinical Analysis of Symptoms and Sexual Life Quality of Patients before and after Treatment of Female Stress Urinary Incontinence with TVT-O

目的探析经闭孔路径阴道无张力尿道中段悬吊术(tension-free vaginal tape-obturator,TVT-O)治疗女性压力性尿失禁前后患者自身症状和性生活质量的效果。方法随机选取2018年1月—2022年12月惠州市第二妇幼保健院收治的女性压力性尿失禁患者100例,按照随机数表法分为对照组(50例,腹腔镜下膀胱颈cooper韧带悬吊术)和分析组(50例,实施TVT-O手术治疗)。记录手术前后症状和尿失禁问卷简表(Incontinence Questionnaire Short Form,ICI-Q-SF)、尿失禁性功能问卷简表(Prolapse/Urinary Incontinence Sexual Questionnaire-12,PISQ-12)和尿失禁影响问卷简版(Incontinence Impact Questionnaire Short Form,IIQ-7)及1 h尿垫实验结果,综合全面分析两组自身症状和性生活质量的变化的情况,以及并发症发生率。结果术后两组患者的ICI-Q-SF、IIQ-7评分均较术前下降,PISQ-12评分较术前上升,术后患者1 h尿垫实验结果较术前明显减少,且分析组优于对照组,差异有统计学意义(P<0.05)。分析组并发症发生率为4.00%,低于对照组的10.00%,差异无统计学意义(χ^(2)=0.614,P>0.05)。结论与腹腔镜下膀胱颈cooper韧带悬吊术相比,女性压力性尿失禁患者在接受TVT-O治疗术后,可显著减少漏尿量,改善患者尿失禁严重程度,改善患者性生活质量,减少并发症,效果理想。

Objective To explore the effect of tension-free vaginal tape-obturator(TVT-O)on the treatment of symptoms and sexual life quality of female patients before and after stress urinary incontinence.Methods 100 cases of female stress urinary incontinence patients admitted to the Second Maternal and Child Health Hospital of Huizhou City from January 2018 to December 2022 were randomly selected and divided into the control group(50 cases,laparoscopic bladder neck cooper ligament suspension)and the analysis group(50 cases,TVT-O surgical treatment was implemented)according to the random number table method.Before and after surgery,the results of the Incontinence Questionnaire Short Form(ICI-Q-SF),the Prolapse/Urinary Incontinence Sexual Questionnaire-12(PISQ-12)and the Incontinence Impact Questionnaire Short Form(IIQ-7)and the 1-h urinary pad experiment were recorded,analyzed the changes in symptoms and sexual quality of life,as well as the incidence of complications in both groups.Results After surgery,the ICI-Q-SF and IIQ-7 scores of patients in both groups decreased compared with the preoperative period,and the PISQ-12 scores increased compared with the preoperative period,and the results of the 1 h urinary pad test of postoperative patients were significantly reduced compared with that of the preoperative period,and the analyzed group was better than the control group,and the differences were statistically significant(P<0.05).The complication rate of the analyzed group was 4.00%,which was lower than 10.00%in the control group,and the difference was not statistically significant(χ^(2)=0.614,P>0.05).Conclusion Compared with laparoscopic cooper ligament suspension of bladder neck,TVT-O treatment can significantly reduce urinary leakage,improve the severity of urinary incontinence,improve the sexual life quality of patients,and reduce complications in female patients with stress incontinence.