经耻骨后与经闭孔途径行尿道无张力悬吊术的疗效及并发症研究

Analysis of therapeutic effect and complication of TVT and TVT-O in the treatment of female stress urinary incontinence

目的:比较经耻骨后经阴道尿道中段无张力悬吊术(tension-free vaginal tape,TVT)和经闭孔经阴道尿道中段无张力悬吊术(tension-free vaginal tape-obturator,TVT-O)治疗压力性尿失禁的疗效和并发症情况。方法:采用随机分组的方法将2002年10月至2011年10月我院泌尿外科的137例女性压力性尿失禁患者采用TVT或TVT-O手术方式进行手术,术后随访重点关注手术后12个月尿控情况和手术时间、术后膀胱损伤、尿潴留、膀胱过度活动症等并发症和住院时间。结果:所有患者完成12个月随访。TVT-O组的平均手术时间明显短于TVT组。TVT组围手术期并发症明显高于TVT-O组。术中出血、住院时间2组间没有差别。术后12个月治愈率,TVT组为93.33%,TVT-O组为94.81%,总的治愈率为94.16%。结论:TVT和TVT-O治疗治疗女性压力性尿失禁的疗效相同。TVT-O组手术时间更短,围手术期并发症更少。

Objectives：To compare therapeutic effect and complication of tension-free vaginal tape（TVT）and tension-free vaginal tapeobturator（TVT-O）in the treatment of stress urinary incontinence. Methods：Totally 137 female patients with stress urinary incontinence from October 2002 to October 2011 in department of urology in our hospital were randomized into two groups. TVT-O and TVT were used in two groups respectively. Urinary control situation,surgical time,perioperative complications including bladder injury,urinary retention,overactive bladder syndrome,etc and hospitalization time at 12 months after the surgery were focused on. Results：All patients completed the 12-month’s follow-up. Average operative time in TVT-O group was significantly shorter than that in TVT group.Perioperative complication rate was significantly higher in TVT group than in TVT-O group. There was no difference in blood loss and hospitalization time between the two groups. Curative rate at 12 months after surgery was 93.33% in TVT group and 94.81% in TVT-O group;the overall curative rate was 94.16%. Conclusion：Both methods are equally effective in the treatment of female stress urinary incontinence. However,TVT-O had shorter operative time and lower overall perioperative complication rate.