腹腔镜下自体筋膜修复术用于治疗女性压力性尿失禁的疗效

Effect of laparoscopic pelvic fascia repair in treatment of female stress urinary incontinence

目的探讨腹腔镜下盆底自体筋膜修复术在治疗女性压力性尿失禁患者中的疗效和安全性,为此类患者提供新的临床手术方案。方法对32例压力性尿失禁伴盆底器官脱垂的患者,在行盆底修复术时同时行耻骨膀胱宫颈筋膜及阴道旁筋膜修复术,术后随访12个月,对患者术前术后的各种临床指标及主观疗效和客观疗效进行对比分析,尿失禁主观疗效采用尿失禁困扰量表UDI-6、尿失禁影响问卷简表IIQ-7中文简体版、盆腔器官脱垂-尿失禁性生活问卷简表PISQ-12,并对手术前后行指压实验、压力诱发试验、棉签实验等进行分析。术后3、6、12个月进行随访。结果患者均顺利完成手术,患者术后随访期内UDI-6、IIQ-7中文简体版、PISQ-12评分均较术前明显下降,手术前后评分比较差异具有统计学意义(P<0.05),术后3、6、12个月评分两两比较,差异无统计学意义(P>0.05)。结论腹腔镜下盆底自体筋膜修复术效果确切稳定,术后并发症少,是治疗压力性尿失禁的有效手段。

Objective: To investigate the clinical effect of laparoscopic pelvic fascia repair in the treatment of female stress urinary incontinence and provide a new surgical plan for patients with pelvic organ prolapse and stress urinary incontinence. Method:32 patients suffering from stress urinary incontinence(SUI) with pelvic organ prolapse,and who are undergoing surgery such aspelvic fascia repair,pubo-vesico-cervical fascia repair and paravaginal fascia repair ,used the questionnaire such as UDI-6,IIQ-7and PISQ-12 and some Clinical test to follow-up and evaluation of curative effect on Postoperative patients for one year,respectively after the operation at 3-month,6-month and12-month for all the patients.Results:All the patients were successfully operated and recover from symptoms of stress urinary incontinence .The scoree of UDI-6 ,ⅡQ-7and PISQ-12 in all the patients decreased significantly after operation at 3-month,6-month and 12-month andthe difference between preoperative and postoperative is statistically significant(P<0.05).However,there were no statistics differece between the three groups(P>0.05).Conclusions:The effect of laparoscopic pelvic autologous fascia repair is accurate and stable,low postoperative complications.It is an Effective treatment for stress urinary incontinence.