新式阴道前后壁修补术同期尿道折叠术治疗阴道前后壁膨出并压力性尿失禁

Simultaneous new anterior and posterior colporrhaphy combined with urethral plication for the treatment of bulge of anterior and posterior vagina with stress urinary incontinence

目的探究新式阴道前后壁修补术同期尿道折叠术治疗阴道前后壁膨出合并压力性尿失禁的治疗效果及远期预后。方法选取2016年4月至2018年4月广东省惠州市第六人民医院诊治的82例阴道前后壁膨出合并压力性尿失禁患者作为研究对象。其中行传统阴道前后壁修补术者设为传统组(n=33),行新式阴道前后壁修补术同期尿道折叠术者设为新式组(n=49),观察两组患者手术疗效、围手术期基本情况、手术前后国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分、术后并发症发生率及复发率。结果新式组患者术后痊愈率为93.88%,明显高于传统组患者,差异具有统计学意义(P<0.05);传统组患者术中出血量与新式组患者比较,差异无统计学意义(P>0.05),手术时间明显短于新式组患者,留置导尿管时间及平均住院天数显著长于新式组患者,差异具有统计学意义(P<0.05);传统组患者术后1个月、6个月和12个月ICI-Q-SF评分均显著高于新式组患者,差异具有统计学意义(P<0.05);传统组患者术后并发症发生率与复发率分别为21.21%和18.18%,新式组患者分别为6.12%和4.08%,传统组患者明显高于新式组患者,差异具有统计学意义(P<0.05)。结论采用新式阴道前后壁修补术同期尿道折叠术治疗阴道前后壁膨出并压力性尿失禁虽可造成手术时间延长,但治疗效果显著,术中出血量较少,可明显缩短患者留置导管时间及住院时间,与传统手术比较,术后并发症发生率及复发率低,优势明显。

Objective To investigate the effect and long term prognosis of simultaneous new anterior and posterior colporrhaphy combined with urethral plication for the treatment of bulge of anterior and posterior vagina with stress urinary incontinence.Methods 82 patients with bulge of anterior and posterior vagina with stress urinary incontinence in our hospital from April 2016 to April 2018 were selected,including 33 patients who underwent conventional anterior and posterior colporrhaphy(conventional group)and 49 patients who underwent new anterior and posterior colporrhaphy combined with urethral plication(new group).The treatment effect of operation,perioperative basic conditions,preoperative and postoperative scores of International Consultation on Incontinence Questionnaire-short Form(ICI-Q-SF),incidences of postoperative complications,and relapse rate were observed in the two groups.Results The cure rate in new group was 93.88%,significantly higher than that in conventional group(P<0.05).There was no significant difference in the intraoperative blood loss between the two groups(P>0.05).The operative time in conventional group was shorter than that in the new group(P<0.05),and length of stay and indwelling catheter time was longer than that in new group(P<0.05).The ICI-Q-SF scores in conventional group at 1 month,6 month,and 12 month after operation were significantly higher than those in the new group,with statistically significant differences(P<0.05).The incidence rates of postoperative complications and recurrence rate in conventional group were 21.21%and 9.09%respectively,higher than those in the new group(18.18%and 4.08%),with statistically significant differences(P<0.05).Conclusions Simultaneous new anterior and posterior colporrhaphy combined with urethral plication for the treatment of bulge of anterior and posterior vagina with stress urinary incontinence has longer operative time and more advantages than conventional surgery including remarkable treatment effect,less intraoperative blood loss,shorter length of stay and indwelling catheter time and low incidence rates of postoperative complications and recurrence rate.