盆腔器官脱垂患者盆底重建手术后新发压力性尿失禁相关影响因素分析

Analysis of related factors of de novo stress urinary incontinence after pelvic floor reconstruction for patients with pelvic organ prolapse

目的探讨盆底重建手术后新发压力性尿失禁的相关因素。方法回顾性分析2005年11月30日至2015年11月30日第三军医大学西南医院妇产科714例接受盆底重建手术患者的临床资料,其中术前无尿失禁的患者共544例,对可能引起患者术后新发压力性尿失禁的相关影响因素进行统计学分析。结果术后新发压力性尿失禁患者有151例,发生率30.5%。其中有糖尿病史、巨大胎儿分娩史、盆腔手术史、盆腔器官脱垂(POP)、手术方式(经腹腔镜阴道顶端骶骨固定术)是术后新发压力性尿失禁的危险因素,其OR值分别为2.575、5.286、1.671和1,而患者其他一般资料和POP分期与之无相关性(P<0.05)。结论盆腔器官脱垂有高危因素的患者盆底重建手术时,可根据患者个体情况及意愿考虑同时实施抗尿失禁手术。

Objective To investigate the related factors of de novo stress urinary incontinence after pelvic floor reconstruction. Methods Retrospectively analyzed the clinical data of 714 patients who acceptted pelvic reconstruction surgery in our hospital from November 30,2005 to November 30,2015. Among the 714 cases, there were 544 cases without preoperative urinary incontinence. The possible related factors of de novo SUI caused by operation were statistically analyzed. Results There were 151 cases of de novo stress urinary incontinence after pelvic floor reconstruction,the incidence was about 30.5%. With a history of diabetes, fetal delivery, pelvic surgery and POP surgery （laparoscopic vaginal apical fixation of sacrum） were the risk factors for de novo stress urinary incontinence after pelvic floor reconstruction,and the OR values were 2. 575,5. 286,1. 671 and 1 respectively. There was no correlation between other general data and POP stage （ P 〈 0.05 ）. Conclusion When performing pelvic floor reconstruction surgery for POP patients with high risk factors, it＇ s better to have urinary incontinence surgery simultaneously according to individual circumstances and wishes.