TVT-O治疗女性压力性尿失禁效果随访(附112例报告)

Follow-up of Transobturator Ttension-free Vaginal Tape-obturator Procedure on Stress Urinary Incontinence in Female:Report of 112 Cases

目的探讨经闭孔尿道中段无张力悬吊术(TVT-O)治疗女性压力性尿失禁(SUI)的手术效果及安全性。方法回顾性分析112例应用TVT-O治疗SUI患者术前及术后2个月、6个月及1年的尿流率及残余尿数据,并行ICI-Q-SF评分综合评价尿道中段悬吊术的效果以及安全性。结果112例患者均获得满意控尿效果,术中无膀胱及尿道损伤,无闭孔血管神经损伤等并发症发生;术后无阴道侵蚀及尿潴留发生;8例术前合并尿急患者中5例术后症状自行改善;6例患者术后新生尿急,口服托特罗定后症状缓解;1例患者于术后3周尿失禁复发,术后8周时再次行TVT-O手术,术后控尿正常,未复发SUI。全部患者术后随访2～20个月,平均12.6个月,无SUI复发,完全改善率94.64%(106/112),症状显著好转率5.36%(6/112),术后最大尿流率无下降(P>0.05),残余尿量无增加(P>0.05),生活质量评分明显改善(P<0.01)。结论TVT-O治疗SUI简单易行,操作安全,并发症发生率低,术后效果满意。

Objective To evaluate the safety and efficacy of transobturator tension-free vaginal tape（TVT-O）by 1-year follow-up.Methods The data of 112 female patients with stress urinary incontinence（SUI）were analyzed retrospectively.Preoperative and postoperative evaluations included physical examination,and urinary symptom,Qmax,post-voiding residual（PVR）,and quality of life scale questionnaires.The anti-incontinence procedure was TVT-O through the anterior vaginal wall.Results All cases clinically improved,one patient experienced recurrence after 2 weeks,and got another TVT procedure 8 weeks later,and got well after the operation.All cases were followed up for 2～20 months in good result.The complete dryness rate was 94.64%（106/112）,5.36% of patients（6/112）showed significant improvement.No leakage occurred.Most patients reported a significant decrease in incontinence severity and improvement in quality of life（P〈0.01）.Conclusion The TVT-O procedure is a safe and efficient surgical treatment method for female SUI.