手术治疗女性压力性尿失禁及盆底器官脱垂对患者生活质量的影响

The Influence of Surgical Treatment of Female Stress Urinary Incontinence and Pelvic Organ Prolapse on Quality of Life of Patients

目的:研究手术治疗女性压力性尿失禁(SUI)及盆底器官脱垂(POP)对健康相关生活质量的影响。方法:选择自2001年1月～2007年1月接受TVT、经闭孔无张力吊带术(TVT-O)、前路植入网带及整体植入网带的患者共142例。109例入选并同意参加本研究。采用改良PFDI-20量表评估术前3个月、术后6～12个月及术后12个月以后患者生活质量,采用方差分析对不同性功能变化情况的PFDI-20评分进行比较。结果:PFDI-20总分及POP评分术后较术前显著降低(P<0.0167),但术后12个月以后与术后6～12个月相比差异无统计学意义(P>0.0167)。术后6～12个月时肛直肠症状评分较术前降低,但差异无统计学意义(P=0.0169),术后12个月以后以术前及术后6～12个月相比均显著改善(P<0.0167)。术后6～12个月及术后12个月以后泌尿系症状较术前显著降低(P<0.0167),并且12个月以后较术后6～12个月亦显著改善(P=0.003)。61例术前术后均有性生活,术后6～12个月,20例(37.0%)术后性功能受损,11例(20.4%)改善,23例(42.6%)无变化;术后12个月以后,21例(34.4%)术后性功能受损,12例(19.7%)改善,28例(45.9%)无变化;术后12个月以后性功能与术后6～12个月相比,无进一步变化;未发现生活质量与性功能之间存在关系。105例(96.3%)患者对手术疗效满意。结论:TVT、TVT-O及经阴道网带治疗SUI及POP疗效显著,术后患者生活质量显著提高。

Objective：To assess the influence of surgery of female stress urinary incontinence（SUI） and pelvic organ prolapse（POP） on health-related quality of life（HRQOL）. Methodss 142 patients were underwent tension- free vaginal tape（TVT） and tension-free vaginal tape obturater（TVT-O） for SUI and tension-free trans-vaginsl mesh for POP from January 2000 to January 2007. 109 patients were selected and agreed to participate in this study. Pelvic Floor Distress Inventory-Short Form 20 CPFDI-20） was used to evaluate HRQOL 3 months before, 6-12 months and 12 month later after the operation. The score of PFDI - 20 of different changes in sexual function were compared by analysis of variance Results： Postoperative PFDI-20 score and POP score fell significantly than that before the operation （P〉0. 0167）, but no statistical difference was observed between 6-12 months and 12 months later （P〉0. 0167）. Colorectal-anal score fell 6-12 months postoperatively than that before the operation with no statistical significance （P=0. 0169）, and it improved 12 months later than before and 6-12 months postoperatively （P〈0. 0167）. Urinary stoic 6-12 months and 12 months later postoperatively hll significantly than that before the operation （P〈0. 0167） ; and it improved 12 months later than 6-12 months after the operation （P=0. 003）. 61 patients were sexually active both before and after the operation. 6-12 months after the operation, 20 patients （37.0 %） complained of sexual function deterioration, 11 patients （20.4 %） reported an improvement, 23 patients （42.6%） reported unchanged. 12 months after the operation, 21 patients（34. 4%） complained of sexual function deterioration, 12 （19. 7%） reported an improvement in inl;ercourse satisfaction , 28 patients（45. 9%） reported unchanged. No statistical association was observed between HRQOL and female sexual function both 6-12 months and 12 month later postoperatively. In all most of the patients105 （96.3 %）were satisfied with the procedure. Conclusions.. TVT, TVT-O and trans-vaginal mesh have significant effect： and improved HRQOL significantly after the operation.