TVT-0治疗女性压力性尿失禁的远期疗效和尿动力学分析

TVT-O in the treatment of stress urinary incontinence： long-term evaluation and urodynamic study

目的评估经闭孑L无张力尿道中段悬吊术（TVT．O）治疗女性压力性尿失禁（SUI）的远期疗效、并发症及尿动力学情况。方法回顾性分析2007年5月至2011年6月24例TVT—O治疗女性SUI患者的临床资料，术后远期随访尿动力学检查、生活质量评分和并发症情况。结果患者术后12～60个月回院完成远期随访。术后远期主观成功21例（87．5％），客观成功22例（91．7％），满意23例（95．8％），生活质量评分（20．0±2．4）分。术前腹压漏尿点压为（56．6±20．1）emH2O（1cmH2O=0．098kPa），术后远期23例〉100cmH2O，1例为66cmH2O，其余尿动力学参数与术前比较差异无统计学意义（P〉0．05）。远期并发症以排尿费力（8例）和外界反射性尿意（4例）多见。结论TVT—O具有操作简便快捷、微创、安全、有效、并发症少的优点，长期随访对于全面评价TVT-O术式远期并发症和疗效持久性有重要意义，术后尿动力学检查对于评价手术疗效和并发症有较大价值。

Objective To evaluate the long-term outcomes, complications and urodynamie parame- ters of using tension-free vaginal tape-obturator （TVT-O） in the treatment of patients with stress urinary in- continence. Methods Preoperative and postoperative evaluations including urodynamic data and quality of life were performed for 24 patients with stress urinary incontinence who were enrolled and treated with TVT-O between May 2007 and June 2011. Results Patients completed long-term postoperative follow-up from 12 to 60 months after surgery. Twenty-one （87.5%） patients achieved long-term subjective success and 22 （91.7%） achieved objective success. Surgical satisfaction and quality of life was high. Long-term postoperative abdominal leak point pressure of 23 patient was greater than 100 cm H20, and the remaining parameters preoperative and postoperative showed no significant differences. Voiding difficulty and external reflection voding desire were the main long-term complications. Conclusions TVT-O is with few compli- cations and high patient satisfaction. It is a simple, safe and effective procedure for treatment of patients with stress urinary incontinence. Long follow-up period is important for the comprehensive evaluation of TVT-O. Postoperative urodynamic study has significance in complications, diagnosis and evaluation.