腹腔镜下Burch术与TVT-O术治疗张力性尿失禁的临床观察

Clinical observations of laparoscopic Burch and TVT-O treatment on patients with stress urinary incontinence

目的比较腹腔镜下膀胱颈悬吊术(Burch术)与经闭孔无张力尿道中段悬吊术(TVT-O术)治疗张力性尿失禁(SUI)的临床疗效。方法回顾性分析2006年1月至2009年1月因SUI手术治疗的68例患者的临床资料。结果 68例患者手术均成功,其中38例患者行腹腔镜下Burch术,30例患者行TVT-O术。Burch术平均手术时间长于TVT-O术(P<0.05);而两组患者在术中出血量、平均住院时间、术后留置导尿管时间等方面比较差异均无统计学意义(P>0.05)。结论腹腔镜下Burch术学习曲线较长,需要一定的手术技巧,手术时间较长,但住院费用相对较少,而TVT-O术方法简单,损伤小,住院时间短,恢复快,但住院费用较高。因此,应根据医院条件及患者自身情况选择合适的治疗方式。

Objective To compare the clinical results of laparoscopic Burchs us pension or tension free vaginal tape-obturator system（TVT-O） treatment for stress urinary incontinence（SUI）.Methods The clinical data of 68 SUI patients after surgery were retrospectively analyzed in the center of obstetrics and gynecology of the stress urinary incontinence central hospital of PLA.Results 68 patients were operated successfully,of which 38 patients underwent laparoscopic burch suspension surgery and 30 patients underwent TVT-O surgery.There was significant differences in the mean operative time（P0.05）.But there were no significant differences in intraoperative bleeding,the time of hospitalization and the mean catheterization time in the two groups（P0.05）.Conclusion Laparoscopic burch suspension surgery needs longer time to learn and requires a certain surgical techniques and longer operative time,but the relatively smaller cost of hospitalization;while TVT-O technique is simple,less damage,shorter hospitalization time and quicker recovery,but higher cost of hospitalization.Therefore,it is necessary to choose the appropriate treatment according to the hospital conditions and patients,requirements.