经阴道尿道中段补片悬吊术治疗压力性尿失禁的临床观察

Clinical research of a butterfly shaped mesh in the treatment of stress urinary incontinence

目的评价经阴道尿道中段补片悬吊术治疗压力性尿失禁(SUI)的近期疗效.方法2003年7月-2004年2月,对确诊为SUI的82例患者,在局部麻醉下行经阴道尿道中段补片悬吊术,并于治疗后1、3、6个月进行随访.根据患者的主诉,以能自控排尿、无尿失禁症状为治愈;尿失禁次数及漏尿情况较术前明显减少为改善;尿失禁症状未改善或加重为无效,观察疗效及并发症.结果82例患者平均手术时间(27±9)min,平均出血量(21±6)ml.72例术后2 h去除导尿管后能自行排尿,24 h后测量残余尿<100 ml,术后48 h出院;10例术后2 h去除导尿管后出现短暂尿潴留,再次留置导尿管48 h后排尿正常,再观察24 h后出院.82例患者出院时78例为治愈,4例(合并脑出血后遗症患者)为改善.76例随访1～6个月,其中74例为治愈,2例为改善.无发生尿潴留、尿路感染及膀胱功能障碍者.结论经阴道尿道中段补片悬吊术治疗SUI方法简单、近期效果确切.

Objective To investigat the effect of a butterfly shaped mesh in treatment of stress urinary incontinence（SUI）. Methods From July 2003 to January 2004, 82 patients with SUI were treated with a butterfly shaped mesh. All patients were followed up at 1st, 3rd, 6th month after operation. According to their complaints, the cure standard of urinary incontinence is that the patient can control micturate by herself. The improved is that the times and volume of urinary incontinence is less than before. The inefficacy is that the patients＇ symptoms is not improved even more than before. Results All patients were operated under local anesthesia. Mean operation time was （27 ± 9） min, and mean blood loss was （21 ± 6）ml. Seventy two patients were able to micturate spontaneously at 2th hour after operation and the volume of residual urine was less than 100 ml after 24 hour behind operation. They were discharged on the next day. 10 patients, an in-dwelling catheter had been used for 48 hours because the volume of residual urine was more than 100 ml. Seventy eight of 82 patients had no signs of stress incontinence. The remaining 4 patients with apoplexy history showed leakage of urine slightly. But their signs were improved obviously after a month. Seventy six patients had been followed up for from 1 to 6 month ： 74 patients were completely cured, and the other 2 patients were improved. No urine retention, infection or bladder dysfunction were observed. Conclusion A butterfly shaped mesh is effective,simple and safe procedure to treat stress urinary incontinence.