单切口无针吊带治疗女性压力性尿失禁的效果及安全性

Clinical efficacy and safety of needleless sling technique in the treatment of female stress urinary incontinence

目的评估单切口无针吊带治疗女性压力性尿失禁(SUI)的临床疗效及安全性。方法选取2015年1月至2017年1月接受手术治疗的37例压力性尿失禁患者的临床资料,其中单纯型压力性尿失禁27例,混合型10例。年龄32～78岁,平均53. 1岁;病史1～20年,平均6. 1年;随访时间7～24个月,平均15. 3个月。所有患者手术前后均填写国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)、尿失禁影响问卷简表(IIQ-7)、有性生活患者手术前后填写性生活质量问卷简表(PISQ-12)。采用Wilcoxon符号秩和检验比较围手术期评分情况。结果 37例患者在局部麻醉下完成手术,术后3个月治愈30例(81. 1%),改善6例(16. 2%),失败1例(2. 7%);术后12个月治愈29例(78. 4%),改善7例(19. 4%),治疗总有效率为97. 3%,失败1例(2. 7%)。IIQ-7及ICIQ-SF问卷术后3、12个月评分与术前相比均显著降低,差异有统计学意义(P <0. 05)。有性生活患者术后PISQ-12评分增高,与术前评分相比差异有统计学意义(P <0. 05)。结论单切口Needleless无针吊带术操作简单,更加微创,并发症发生更少,是治疗女性压力性尿失禁的有效术式。

Objective To evaluate the clinical efficacy and safety of needleless single incision inthe treatment of female stress urinary incontinence(SUI).Methods The clinical data of 37 patientswith pressure incontinence who received surgical treatment from January 2015 to January 2017 wereselected,including 27 cases of pure pressure incontinence and 10 cases of mixed type.The average agewas 53.1 years.The medical history was 1-20 years,with an average of 6.1 years.The follow-up timewas 7-24 months,with an average of 15.3 months.All patients completed iciq-sf,iiq-7,and sexquality questionnaire before and after surgery(pisq-12)before and after surgery.The wilcoxon rank sumtest was used to compare the preoperative scores.Results Thirty-seven cases completed the operationunder local anethesia,30 patients(81.1%)were cured 3 months after surgery,6 cases(16.2%)wereimproved,1 case was failed(2.7%);29 cases(78.4%)were cured 12 months after surgery(78.4%),7 cases were improved(19.4%),and the total effective rate was 97.3%(2.7%),1 casewas failed.The score of IIQ-7 and iciq-sf at 3 and 12 months after operation were significantly lower thanthose before operation(P<0.05).The postoperative score of pisq-12 was increased,there wassignificant difference compared with the preoperative score(P<0.05).Conclusions Single incisionneedleless sling operation is simple,more minimally invasive and has fewer complications,which is aneffective method for the treatment of female stress incontinence.