新式阴道前壁补片修补术在女性压力性尿失禁中治疗效果评估

Evaluation of the curative effect of a new-type operation with vaginal mesh-repair for female stress urinary incontinence

目的:探讨新式阴道前壁补片修补术术式的创新性及优、缺点,以及其对女性压力性尿失禁(SUI)的近期手术疗效。方法:对2009年1月至2012年2月我院收治的106例女性SUI患者行新式阴道前壁补片修补术。采用主观评价尿失禁问卷简表(ICIQ-SF)、客观评价尿垫试验等方法评价该术式的近期手术疗效。与经典文献Burch手术及TVT等术后1年治愈率比较,探讨此手术的创新性及优、缺点。观察患者的围手术期及术后并发症情况。结果:新式阴道前壁补片修补术术后1年,患者的治愈率为90.57%,ICIQ-SF评分明显降低(P<0.001)。与Burch手术、TVT等术后1年的治愈率比较,无显著差异(P>0.05)。患者围手术期的尿路感染、排尿不尽等并发症的发生率为9.43%,尚未发现严重术后并发症。结论:本新式阴道前壁补片修补术符合手术目的预期,具有微创化、经济、近期治愈率高和术后并发症率低等优势,但中远期治疗效果需继续随访。

Objective： To investigate the clinical short-term effects, innovation, advantages and disadvantages of a new vaginal mesh-repair surgery against stress urinary incontinence （SUI）. Methods：From Jan. 2009 to Feb. 2012,106 cases of female SUI treated with the new surgery. Short term outcomes after surgery were analyzed by objective method （ICIQ-SF）, subjective method（peal-test） and complications. Compare and analyze 1 year cure rate of the new operation with the Butch retropubic urethropexy and tension-free vaginal tape procedure （TVT） from classics literature. The innovation, advantages and disadvantages were investigated. Resuits： According to ped-test evaluation, the successful rate of the new operation reached 90.57%. The analysis found no difference in cure rates at 1 year among this operation, the Butch and TVT. The complications rate such as urinary infection was 9.43 %. There was no serious complications. And ICIQ-SF scores significantly reduced compared with the preoperative （P〈0. 001 ）. Conclusions ：The short term effect of the new vaginal mesh-repair surgery are effective, economic and reliable to cure the female with SUI.