经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁手术技巧及临床疗效分析

Clinical efficacy and operation skills of TOT for treatment of female stress urinary incontinence

目的:探讨经闭孔尿道中段无张力悬吊术(trans-obturator tape,TOT)治疗女性压力性尿失禁(female stress urinary incontinence,FSUI)的临床疗效并总结其手术技巧。方法:对我院2013年7月~2015年12月收治的35例女性压力性尿失禁患者资料进行回顾性分析,所有患者经术前准备后行TOT。结果:33例患者术后拔除导尿管小便自解,2例出现排尿困难,给予尿道扩张后小便自解,2例出现急迫性尿失禁,给予托特罗定口服治疗后好转,1例术后出现腿痛,术后1周明显好转。随访6~36个月,尿失禁症状均无复发。结论:经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁疗效确切,掌握手术技巧可以减少并发症的发生。

Objective：To explore the clinical efficacy of trans-obturator tape（TOT）for the treatment of female stress urinary incontinence（FSUI）and to summarize the operation skills.Method：Data of 35 patients with FSUI who were admitted into First Affiliated Hospital of Anhui Medical University from July 2013 to December2015were analyzed retrospectively.All patients underwent TOT after preoperative preparation.Result：Thirtythree patients can urinate automatically after being pulled out urinary catheter.Two patients complicated with dysuria were asked to give urethral dilatation and keep catheterization for several days,then they recovered.Other two patients were found urge incontinence,and improved after being given tolterodine.One case had the leg pain,and improved one week later.Patients were followed up for 6to 36 momths,and no recurrence was found.Conclusion：TOT has an exact effect for treating FSUI.Mastering surgical skills can reduce the occurrence of complications.