张力性尿失禁病人不同术式比较

Comparison of different surgical procedures for urinary stress incontinence

目的探讨张力性尿失禁不同术式的优劣。方法对因张力性尿失禁或伴有张力性尿失禁而进行手术治疗的９５例病人（包括经阴道修补术６３例，经腹库伯韧带悬吊术２３例）进行了回顾性分析。结果术后３个月的治愈率，库伯韧带悬吊术和阴道前壁修补术分别为９３％（２６／２８）和６９％（３１／４５）（Ｐ＜０．０５）；术后１年的治愈率分别降至７４％（１４／１９）和５８％（２３／４０）（Ｐ＞０．０５）。术后性生活感觉异常情况为，库伯韧带悬吊术和阴道前壁修补术分别为４％（３／４５）和７％（１／２８）。术后插尿管天数和次数，库伯韧带悬吊术多于阴道前壁修补（Ｐ＜０．０５）。结论张力性尿失禁的术后治愈率，３个月时库韧带悬吊术优于阴道前壁修补术，１年时两种术式相似。

Objective Comparison of different surgical procedures for urinary stress incontinence (USI).Methods 95 patients with and/or accompanying USI were treated operatively in a prospectively randomized manner.Results The cure rate of colposuspension group 3 months after operation was 93% and was higher than 69% after Kelly operation (P<0.05). But the cure rate 12 months after operation decreased to 74% and 58% respectively (P>0.05). The percentage of abnormal sexual life was lower in the colposuspension group (4%) than that of those having Kelly operation (7%). The average days and times of intubation in the colposuspension group were more than in Kelly operation group (P<0.05). Conclusion The cure rate of colposuspension 3 months was better than that of the Kelly operation. The cure rate at 1 year was similar in the two procedures. Transient urinary retention occurred more after in the colposuspension group.