TVT术治疗女性压力性尿失禁疗效观察(附11例报告)

Clinical Effect of Tension-free Vaginal Tape Procedure for Female Stress Urinary Incontinence: 11 Cases Report

目的观察经阴道无张力尿道悬吊术（tension-free vaginal tape procedure,TVT）对女性压力性尿失禁的临床治疗效果。方法采用TVT术对11例女性单纯性真性压力性尿失禁患者进行矫治。结果 11例均一次治愈,手术时间平均29（23~40）min,术后住院时间2~3 d。术后24 h拔除尿管后均可排尿,1例排尿费力1 d后自行缓解;1例下腹疼痛、腹胀,经对症处理后缓解。术后随访4年,无膀胱损伤、排尿困难、吊带感染、耻骨炎、伤口感染等并发症。术后1年有尿不尽感1例,B超检查无残余尿;术后18个月尿流分叉1例,经尿道扩张1次后缓解;有异物感3例。术后4年最大尿流率平均23.3（16.3~29.8）ml/s,均未再发生尿失禁。结论 TVT术是治疗女性压力性尿失禁的一种简单、安全、有效方法 ,长期疗效有待进一步观察。

Objective To evaluate the effect of tension-free vaginal tape procedure（TVT） in treating female stress urinary incontinence.Method A total of 11 women suffered genuine stress urinary incontinence were treated by TVT.Results The mean operation time was 29 minutes（ranged 23～40 minutes） and the mean hospital stay was 2 to 3 days.All 11 patients were cured and the clinic symptoms disappeared after the operation.All cases recovered urination after extraction of urethral catheter.Difficulty of urination was found in 1 case and spontaneous remission after one day,hypogastralgia and abdominal distension was in 1 case and relieved by expectant treatment.All cases were followed up for 4 years.No severe complications such as bladder injury,retropubic hematomas,dysuresia,and infection were found.Dripping of urination was in 1 case one year after TVT and not found residual urine by B-ultrasound exam.Bifurcation of urination was in 1 case 18 months after TVT and relieved by urethral sounding once time.Foreign body sensation was found in 3 cases.The maximum flow rate was 16.3 to 29.8 ml/s with an average of 23.3 ml/s four years after TVT.There was no urinary incontinence reoccurred.Conclusions TVT is a simple,safe,effective and mini-invasive procedure for female stress urinary incontinence with low incidence of complications.Its long-term effect needs to be further studied.