TVT—EXACT治疗Ⅲ型女性压力性尿失禁的疗效和安全性的分析

Efficacy and safety of TVT-EXACT procedure for treatment of ISD female stress urinary incontinence

目的探讨新型经耻骨后尿道中段无张力悬吊术（TVT-EXACT）治疗Ⅲ型女性压力性尿失禁（SUI）的疗效及并发症。方法采用回顾性方法，收集本院2013年11月至2016年6月期间收治的20例行TVT-E术的Ⅲ型压力性尿失禁患者的资料，观察手术的疗效及并发症的情况。结果手术时间19～25（20.7±1.6）min，术中出血量20～50 ml。术中均无膀胱、尿道损失，无血管、神经损伤。3例患者因术后排尿困难，予延长导尿时间及尿道扩张，处理后症状均好转，复测尿流率及残余尿均正常。2例混合性尿失禁患者，术后均存在急迫性尿失禁，经抗胆碱能药物治疗后症状均逐渐好转。均无阴道、尿道侵蚀。疗效判定：治愈15例（75%），好转5例（25%），无效0例，有效率100%。结论TVT-E术操作简便、微创，对Ⅲ型压力性尿失禁患者的治疗安全有效。但本研究手术数量及术后随访时间有限，长期疗效仍需要大量的临床数据和随访资料证明。

Objective To investigate the efficacy and complication of Tension-free Vaginal Tape （TVT）-Exact for the treatment of type-lll female stress urinary incontinence （SUI）. Methods A total of 20 type-Ill SUI patients enrolled from November 2013 to June 2016 were retrospectively analyzed. The efficacy and complication of the surgery were evaluated. Results The mean operation time was （20. 7 ± 1.60）min （range, 19 -25 min）. The blood loss was 20 -50 ml. There were no intraoperative bladder or urethral injury, and no vessel or nerve damage. 2 cases with mixed SUI were relieved by medicine. No case had urethral or vaginal erosion. Therapeutic efficacy： 15 cases were cured （75%）, 5 cases were improved （25%）, and no case was ineffective. Conclusions TVT-E is a simple, min-invasive, safe and effective surgery for type-Ill SUI. While the long-term efficacy needs great amount of clinical data and long-term follow-up to prove.