尿道中段童氏前路悬吊术与经阴道尿道中段悬带术治疗女性压力性尿失禁疗效比较

Comparison of Tong＇s ventrofixation and intravaginal slingplasty in the treatment of female stress urinary incontinence

目的评价尿道中段童氏前路悬吊术治疗女性压力性尿失禁的疗效。方法选有压力性尿失禁患者40例，所有患者均按知情同意的原则，自愿选择尿道中段童氏前路悬吊术或经阴道吊带术（IVS）。行IVS13例（IVS组），尿道中段童氏前路悬吊术27例（尿道中段童氏前路悬吊术组）。对2组患者术中情况进行对比分析并对治疗后的效果进行定期随访。结果2组治疗尿失禁所用的时间基本相同，约20～35min。尿道中段童氏前路悬吊组术中、术后均未发生血管、神经、尿道、膀胱损伤；术后发生排尿费力2例，排尿时感淋漓不尽，均于术后1～2周自然恢复，未特殊治疗；尿潴留3例，于24h拔尿管后，B超提示尿潴留，再次留置导尿3～8d后，B超提示残余尿正常。IVS组术中未发生血管、神经、尿道、膀胱损伤；术后发生排尿困难2例，1例为排尿费力，1例出现尿潴留；术后随访时发现1例膀胱损伤。结论IVS与尿道中段路悬吊术均在临床上取得良好的治疗效果。IVS存在膀胱损伤风险且费用昂贵。而尿道中段童氏前路悬吊术手术费用低，手术操作范围小，手术风险小，有临床推广价值。

Objective To evaluate the effect of Tong＇s ventrofixation for female stress urinary incontinence （SUI）. Methods There were 40 patients with stress urinary incontinence complicated with organ prolapse 27 of them underwent Tong＇s ventrofixation （Group A）and the others underwent intravaginal slingplasty （ IVS） （Group B）. The patients were all followed up and the treatment effect was evaluated after operation. Results Operation time was about twenty to thirty-five minutes in both of the two groups. No patients were injured in blood vessel, nerve,urethra or bladder during and after operation in the group of Tong＇s hammock. Two cases with dysuria after Tong＇s hammock recovered naturally without special therapy in one to two weeks. Three cases were kept with indwelling catheter for three to eight days because of urine retention by ultrasound. No patients were injured in blood vessel, nerve,urethra or bladder during operation in the IVS group, but one case was found to have bladder damage when followed up after operation. One ease appeared to have dysuria and one ease claimed having urine retention after IVS. Conclusion Tong＇s hammock and IVS are an effective operation with less operation cost,minor operation scope, less operation risk.