TVT-O治疗女性压力性尿失禁48例临床分析

TVT-O Treatment of Female Stress Urinary Incontinence Clinical Analysis of 48 Cases

目的 探讨经闭孔尿道中段无张力悬吊术（TVT-O）治疗女性压力性尿失禁（SUI）的手术疗效及安全性。方法 回顾性分析48例应用TVT-O手术治疗SUI患者术前及术后2个月、6个月及1年的疗效,评价尿道中段悬吊术的效果及安全性。结果 1单纯行TVT-O手术平均用时20（11-30）min,术中平均出血14（7-20）mL。2患者术后排尿正常,术中无尿道及膀胱损伤,无神经及血管损伤等并发症发生。3 5例术前合并尿急患者中4例术后症状自行改善,2例患者术后尿急,口服托特罗定后症状缓解。分别于术后2个月、6个月和1年随访,疗效评价主要依靠患者的主观感受,即尿失禁症状的改善程度和满意度,以及指压实验和垫实验。结论 TVT-O手术操作简便,创伤小,并发症少,疗效满意,是治疗女性SUI的安全有效方法。

Objective To evaluate the safety and efficacy of transobturator tension-free vaginal tape （TVT-O） by 1-year follow-up. Methods The data of 48 female patients with stress urinary incontinence （SUI） were analyzed retrospectively. Preoperative and postoperative evaluations included physical examination, and urinary symptom, Qmax, post-voiding residual （PVR）, and quality of life scale questionnaires. The anti-incontinence procedure was TVT-O through the anterior vaginal wall. Results ①The mean time of operation was 20 minutes （11-30 min）,mean bleed loss was 14 mL（7-20 mL）. ②The patients had normal urination after the surgery, the surgical was very smooth without damage to the urethra and bladder, there weren＇t nerve and blood vessel damage complications during the operation. ③There were 4 cases improved themselves among the 5 merge urgency patients before the operation, urgency arised in 2 cases after surgery, and the symptoms was mitigated after oral tolterodine. The 1 h pad test of 2 months, 6 months and 1 year after operation judging the efficacy of the operation rely mainly on the patient＇s subjective experience, that the degree of improvement of symptoms of urinary incontinence and satisfaction, as well as experimental and shiatsu mat experiment. Conclusions TVT-O is a surgery that is easy to operate. It has few complications, satisfied short-term cure rate and quality of life. The impact on sexual life and long-term results still need further evaluation.