经闭孔无张力阴道吊带术治疗女性压力性尿失禁的临床观察

Clinical research of tension free vaginal tape obturator technique in female stress urinary incontinence

目的观察经闭孔无张力阴道吊带术(TVT-O)治疗女性压力性尿失禁(SUI)的临床疗效及手术安全性。方法对32例中、重度女性压力性尿失禁患者采用TVT-O手术治疗,术后1个月、6个月行尿流率及残余尿测定,并行ICI-Q-SF评分,综合评价手术效果及手术安全性。结果32例患者TVT-O术后均获得满意控尿效果,其中1例患者出现排尿困难症状,经再次留置导尿、指导膀胱功能锻炼及消炎、理疗等保守治疗后缓解。平均手术时间(15±3)min,术中出血量(11±2)mL;术后留置导尿管2～4d,平均2.8d;平均住院时间5～7d。32例患者全部顺利完成手术,无膀胱、尿道、直肠损伤,无耻骨后血肿形成,无尿失禁症状复发,无植入物排斥、感染等并发症发生。术后最大尿流率无下降(P>0.05),残余尿量无增加(P>0.05),国际尿失禁症状评分明显改善(P<0.01)。结论TVT-0治疗女性SUI疗效明显,安全性高。对重度者改善更明显。

Objective To investigate the efficacy and safety of tension free vaginal tap obturator technique （TVT-O） in the treatment of female stress urinary incontinence. Methods Thirty-two patients underwent the procedure of TVT-O. The urinary flow rate and residual urine were detected 1 month and 6 months after the operation. ICI-Q-SF score was assessed to evaluate theefficacy and safety of the operation. Results All operations were successfully conducted without major complications. The clinical symptoms disappeared after operation in all patients. One patient developed voiding difficulty, which was relieved after catheterization, bladder function improvement, and anti-inflammation treatment. The mean operative time was （15±3） min, mean intra-operative blood loss was （11±2） mL, mean hospital stay was 5-7 d, mean catheterization time was 2.8 d. Post-operative Qmax was not decreased （P〉0.05） and residual urine was not increased （P〉0. 05）. Most patients reported a significant decrease in incontinence severity and improvement in quality of life （P〈0. 01）. Conclusion The TVT-O is effective and safe for female stress urinary incontinence.