改良TVT-O术治疗女性压力性尿失禁疗效分析

A primary results of tension-free vaginal tape for surgical treatment of female stress urinary incontinence

目的探讨经闭孔无张力尿道中段悬吊术（transobturator vaginal tape inside-out，TVT-O）治疗女性压力性尿失禁（stress urinary incontinence，SUI）的初步疗效和手术安全性。方法对压力性尿失禁患者21例行改良TVT-O术，并对手术效果和并发症进行初步的随访研究。结果平均手术时间30min，平均出血量35ml，平均住院天数5．2d。术后尿失禁症状均得到控制或减轻，1例患者出血局部血肿，经保守治疗后好转，随访6～12个月无复发。结论改良TVT-O术治疗女性压力性尿失禁疗效确切，具有手术时间短、创伤小、不损伤膀胱、费用低等优点。

Objective To present the primary clinical results of tension-free vaginal tape for surgical treatment of female stress urinary incontinence. Methods A prospective open study using a standardized protocol for pre-and post-operative evaluation. 21 cases consecutive women participated in the study. All suffered from genuine stress incontinence or mixed urinary incontinence. A prolene tape around mid-urethra was implanted via a minimal vaginal incision. The procedure is carried out under epidural anesthesia or local anesthesia. Results The mean operation time 30 min, average blood loss was 35 ml, mean postoperative stay duration were 5.2 days （range 4-9）. 95.9% of the women with genuine stress incontinence were cured and another 4. 1% significantly improved. 1 case of hematoma observed and cured with conservative treatment. Followed up for 6 to 12 months without recurrence. Conclusion The modified TVT-O surgical treatment of female stress urinary incontinence is effective, with shorter operative time, less invasive, and low cost.