改良经闭孔无张力阴道悬吊术对女性压力性尿失禁伴轻度阴道前壁膨出的影响

Effects of a Modified Tension-Free Vaginal Tape-Obturator on Female Stress Urinary Incontinence With Slight Anterior Vaginal Prolapse

目的探讨改良经闭孔无张力阴道悬吊术(tension-free vaginal tape-obturator,TVT-O)对伴轻度阴道前壁膨出女性压力性尿失禁(stress urinary incontinence,SUI)的治疗效果。方法选择2006年11月至2008年1月哈尔滨211医院采用童晓文经闭孔无张力阴道悬吊术式治疗的女性压力性尿失禁患者28例为研究对象。其中,13例伴阴道前壁膨出(轻度为11例,中度为2例),15例为单纯性压力性尿失禁。结果本组28例患者术后压力性尿失禁症状均消失,平均手术时间为20 min,平均出血量为40 mL;术后6个月内随访结果示,本组10例术前伴阴道前壁轻度膨出者(1例失访)中,2例膨出明显改善,其他均未加重。结论改良经闭孔无张力阴道吊带术治疗压力性尿失禁具有手术创伤小、悬吊疗效可靠的特点,并适合于伴有轻度阴道前壁膨出的压力性尿失禁患者。

Objective To investigate effects of a modified tension free vaginal tape-obturator （TVT-O） on treating female stress urinary incontinence （SUI） with slight anterior vaginal prolapse. Methods 28 females with stress urinary incontinence accepted a modified tension-free vaginal tape- obturator surgery by suspending mid urethra, including 13 eases with anterior vaginal prolapse （11 cases were slight,2 cases were midrange）,and 15 cases with pure stress urinary incontinence. Results All patients showed no stress urinary incontinence symptoms completely after the modified tension-free vaginal tape-obturator surgery, with average operation time of 20 minutes, and average intraoperative hemorrhage volume was 40 mL. A 6-month follow-up of 27 patients revealed no recurrence, and previous slight anterior vaginal prolapse in 10 patients become less prominent, while in 2 patients improved significantly. Conclusion The modified tension free vaginal tape-obturator surgery is effective, minimally invasive, less complicated, and suitable for female stress urinary incontinence with slight anterior vaginal prolapse patients.