探讨膀胱颈抬高术联合尿道中段折叠耻骨降支悬吊术在女性SUI中的应用

Investigation of the Application of Bladder Neck Elevation Combined with Mid-Urethral Folding Descending Ramus Pubis Suspension in Female SUI

目的:探讨经闭孔无张力尿道中段悬吊带术(TVT-O)与膀胱颈抬高术联合尿道中段折叠耻骨降支悬吊术治疗女性压力性尿失禁(SUI)的临床应用价值。方法:选取2019年7月—2020年7月我院收治的62例女性SUI患者,按不同手术方式分为两组,每组各31例,研究组进行膀胱颈抬高术、尿道中段折叠耻骨降支悬吊术联合治疗;对照组进行TVT-O治疗。比较两组患者手术有效率、并发症发生率、住院费用、治疗后生活质量改善等情况,观察两组患者各项指标之间差异。结果:经数据统计分析,发现两组患者手术有效率相当,差异无统计学意义(P>0.05)。研究组术后并发症发生率、住院费用均明显少于对照组,差异有统计学意义(P<0.05)。两组患者术后生活质量评分均较术前有明显提升(P<0.05)。结论:TVT-O和膀胱颈抬高术、尿道中段折叠耻骨降支悬吊术联合治疗女性SUI效果相当,均为有效治疗方式,膀胱颈抬高术联合尿道中段折叠耻骨降支悬吊术手术成本更低,术后生活质量更高,安全性高,值得临床应用。

Objective:To investigate the clinical application value of transobturator tension-free mid-urethral sling(TVT-O)and bladder neck elevation combined with mid-urethral folding descending ramus of the pubis in the treatment of female stress urinary incontinence(SUI).Methods:A total of 62 female SUI patients admitted to our hospital from July 2019 to July 2020 were selected and divided into two groups according to different surgical methods,with 31 patients in each group.The research group performed combined treatment of bladder neck elevation and mid-urethral folding and descending pubic branch suspension.The control group was treated with TVT-O.Operation efficiency,complication rate,hospital costs and improvement of quality of life after treatment were compared between the two groups,and the differences in various indicators between the two groups were observed.Results:After statistical analysis of data,it was found that the two groups of patients with the same effective rate,there was no statistical significance(P>0.05).The incidence of postoperative complications and hospital costs in the study group were significantly lower than those in the control group,with statistical significance(P<0.05).The scores of postoperative quality of life in both groups were significantly improved compared with those before surgery(P<0.05).Conclusion:TVT-O,bladder neck elevation,and mid-urethral folding and descending pubic artery suspension combined to treat female SUI are equally effective,and both are effective treatment methods.Bladder neck elevation combined with mid-urethral folding descending ramus pubis suspension has lower surgical cost,the postoperative quality of life is higher,the safety is high,and it is worthy of clinical application.