无张力尿道中段悬吊术治疗女性压力性尿失禁并发症分析

Analysis on complications of female stress urinary incontinence treated with tension-free mid-urethral sling suspension

目的：提高对尿道中段悬吊术（TVT TVT-O）并发症的诊断及处理能力。方法：收集2006年1月2009年10月应用TVT和TVT-O治疗的86例女性压力性尿失禁患者术中及术后随访出现的并发症情况,对其临床症状、体征、诊断与处理进行分析。结果：出现并发症19例,包括膀胱穿孔2例,经重新调整穿刺纠正;尿潴留8例,予留置导尿,尿道扩张,排尿正常;下肢疼痛和耻骨后血肿各2例,经保守治疗好转;尿急症状2例,口服托特罗定症状缓解;膀胱结石1例,经膀胱切开取出吊带组织并缝合治愈;吊带阴道侵蚀2例,修剪外露吊带治愈。结论：认识尿道中段悬吊术相关并发症的表现可提高诊断和处理该手术并发症的能力。

Objective：To improve the diagnostic and processing ability of complications of tension-free vaginal tape-obturator（TVT-O）.Methods：86 women with female stress urinary incontinence treated with TVT and TVT-O from January 2006 to October 2009 were selected,the intraoperative and postoperative complications were observed;their clinical symptoms,physical signs,diagnosis and treatment were analyzed.Results：19 cases were found with complications,including 2 cases with bladder perforation（corrected after re-regulation of puncture position）,8 cases with urinary retention（corrected after indwelling catheter and urethral dilatation）,2 cases with lower limb pain（corrected after conservative treatment）,2 cases with retropubic hematoma（corrected after conservative treatment）,2 cases with urgency of urination（relieved by tolterodine orally）,1 case with bladder stone（cured by vesicotomy and removing sling by surgery） and 2 cases with sling vaginal erosion（cured by trimming the exposed sling）.Conclusion：Recognizing the manifestations of TVT related complications can improve the abilities of diagnosis and treatment.