阴道无张力尿道中段悬吊术与单纯盆底修复手术治疗压力性尿失禁临床疗效比较

Comparative Study of Tension Free Vaginal Tape and Single Pelvic Organ Prolapse Repair for Stress Urinary Incontinence

目的：比较压力性尿失禁合并盆腔脏器脱垂（POP）的患：者，行阴道无张力尿道中段悬吊术（TVT）与单纯盆底修复术的疗效差异。方法：32例压力性尿失禁或同时伴有不同程度盆腔脏器脱垂的患者，20例接受TVT手术，12例未行TVT手术，只进行了盆底修复或（和）其他妇科手术，术前、术后进行评估。结果：手术总时间、术中出血量、术后住院时间，两组患者之间没有统计学差异。TVT组术中出现膀胱穿孔1例，术后两组均无严重并发症。TVT组随访4～26个月，90％完全治愈，10％明显改善。单纯修复组随访7—24个月，治愈率66．7％，1例复发，1例加重。结论：TVT治疗女性压力性尿失禁是一种安全、有效的手术，与盆底修复同时进行可显著提高压力性尿失禁的治愈率。

Objective：To compare the efficiency of tension vaginal tape （TVT） and single repair of pelvic organ prolapse（POP） in treatment of female stress urinary incontinence（SUl）or with POP. Methods： There were thirty-two cases with proven SUI or accompanied POP,twenty of them were undergone the TVT procedure and the others were repaired alone. Results： Between two groups,there were no significant difference in total operation time, bleeding and hospitalization time after operating. Bladder injury happened once in TVT group and no severe complications appeared in both groups after operating. In TVT group, patients were followed up for 4 - 26 months,90% completely cured, 10% distinctly improved. In single repair group, patients were followed up for 7 - 24 months, 66.7% cured, one patient recurred,and one patient became aggravated.Conclusions：TVT procedure is an effective and safe surgery in the treatment of SUI and the cure rate can be obviously improved by applying TVT and POP repair simultaneously.