改良的TVT-O与单切口尿道中段悬吊术治疗女性压力性尿失禁的疗效比较

Efficacy of revised tension-free vaginal tape obturator and single-incision tape TVT secur in the treatment of female stress urinary incontinence.

目的:比较改良的TVT-O与单切口尿道中段悬吊术(TVT-S)治疗女性压力性尿失禁(SUI)的临床疗效。方法:回顾分析2008年4月至2012年7月中山大学附属第一医院收治的60例SUI患者的临床资料,其中28例行改良TVT-O治疗,32例行TVT-S治疗。通过压力诱发试验及指压试验评价客观疗效,国际尿失禁咨询委员会尿失禁问卷表简表(ICIQ-SF)评价主观疗效,同时分析术中及术后并发症等。结果:两组的平均手术时间、术中出血、术后住院天数均无显著差异(P>0.05)。TVT-S组尿管留置时间短于TVT-O组(P<0.05);TVT-O与TVT-S组的治愈率分别为84%、80%,复发率分别为14.3%、16.7%,均无显著差异(P>0.05)。两组的术后ICIQ-SF评分均较术前显著改善(P<0.05),但两组比较无显著差异(P>0.05)。两组术中均未出现严重并发症。结论:改良的TVT-O与TVT-S疗效相当,疼痛等并发症发生率较低,可用于治疗SUI。

Objective：To compare the efficacy of revised tension-free vaginal tape obturator（TVT-O） and single-incision TVT SECUR（TVT-S） in the treatment of stress urinary incontinence（SUI）.Methods：We retrospectively analyzed the clinical data of patients who had anti-incontinence surgery between Apr.2008 and Jul.2012.And compared the objective and subjective efficacy and early failure rate of the revised TVT-O and TVT-S by objective criteria（cough test） and subjective criteria using the International Consultation on Incontinence Questionnaire-Short Form（ICIQ-SF）.The intraoperative and postoperative complications were also analyzed.Results： There were 28 patients in the TVT-O group while 32 patients in the TVT-S group.The mean operating time,intraoperative blood loss and inpatient days after surgery between the two groups had no significantly difference（P0.05）.The catheter retention time of the TVT-O group was longer than the TVT-S group.The cure rate of the TVT-O group and the TVT-S group was 84% and 80% respectively with the recurrence rate being 14.3% and 16.7% respectively.The score of ICIQ-SF of the two groups were both decreased after surgery,and there was no difference between the two groups.No serious complications were found in the two groups.Conclusions： Our study demonstrated that both revised TVT-O and TVT-S can reach a cure rate above 80% which has little complications and both are reliable to treat SUI.