三种中段尿道吊带术治疗女性固有括约肌障碍型压力性尿失禁疗效及安全性

Effect and safety of three types of middle urethral sling on female stress urinaryincontinence with intrinsic sphincter disorder

目的:探究不同中段尿道吊带术治疗女性固有括约肌障碍型(ISD)压力性尿失禁(SUI)的疗效以及安全性。方法:2016年8月-2018年8月收治ISD型SUI患者90例,随机分为三组,各30例。TOT组经闭孔无张力尿道吊带术治疗;TVT组经阴道无张力尿道中段悬吊术治疗;Ajust组采用单切口可调节AjustTM吊带术治疗。比较三组治疗效果。结果:TVT组与Ajust组治疗总有效率均高于TOT组,差异有统计学意义(P<0.05)。TVT组与Ajust组短期排尿障碍发生率均高于TOT组,TVT组远期排尿障碍发生率高于其余两组,差异有统计学意义(P<0.05)。TVT组术后1年PVR指标水平高于术后6个月,Qmax指标水平低于术后6个月,差异有统计学意义(P<0.05)。结论:采用TVT、单切口可调节AjustTM吊带术治疗ISD型SUI患者,疗效满意,后者更加安全,但是远期疗效仍然需要继续随访。

Objective:To explore the efficacy and safety of different types of middle urethral sling in the treatment of female inherent sphincter disorder(ISD)stress urinary incontinence(SUI).Methods:From August 2016 to August 2018,90 SUI patients with ISD type were enrolled,they were randomly divided into three groups with 30 cases in each group.The TOT group was treated with tension-free urethral sling through obturator.The TVT group was treated with transvaginal tension-free urethral sling treatment.The Ajust group was treated with single incision adjustable AjustTM sling.The therapeutic effects of the three groups was compared.Results:The total effective rate of treatment in TVT group and Ajust group was higher than in TOT group,the difference was statistically significant(P<0.05).The incidence of short-term dysuria in TVT group and Ajust group was higher than in TOT group,the TVT group had higher incidence of long-term dysuria than the other two groups,the differences were statistically significant(P<0.05).In the TVT group,the level of PVR at 1 year was higher than at 6 months after operation,and the level of Qmax was lower at 6 months after operation,the differences were statistically significant(P<0.05).Conclusion:Using TVT,single incision adjustable AjustTM sling surgery to treat patients with ISD type of SUI,the curative effect is satisfactory,the latter is more safe,but the long-term effect still needs to be followed up.