Solyx^(TM)单切口吊带系统治疗女性压力性尿失禁的临床研究

Clinical study of Solyx^(TM)system:modified sling system for the treatment of female stress urinary incontinence

目的探讨Solyx^(TM)单切口吊带系统治疗女性压力性尿失禁(SUI)的临床疗效及安全性。方法对2020年8月—2021年8月在信阳市中心医院泌尿外科住院并确诊为SUI女性患者应用Solyx^(TM)单切口吊带系统进行尿道中段无张力悬吊,了解并评价其治愈率和术后并发症等。结果26例患者,年龄44~85岁,病程1~27年,分娩1~6次,体重指数(BMI)19.6~26.4 kg/m^(2),腹腔漏尿点压(ALPP)56~106 cmH_(2)O,最大尿流率(Q_(max))22~43 mL/s。26例患者手术均获得成功,手术时间12~28 min,失血量5~20 mL,术后住院日2~5 d。无膀胱、尿道、肠管和阴道损伤,无会阴血肿和切口感染。拔尿管后尿失禁均消失,咳嗽试验阴性。2例排尿费力,经尿道扩张重新导尿48 h后症状消失。1例尿潴留小便无法排出,经再次手术处理后排尿通畅无尿潴留,尿失禁症状消失;无新发尿急;尿频1例口服托特罗定1周后治愈。随访2~12个月尿失禁均无复发。结论Solyx^(TM)单切口吊带系统治疗女性SUI创伤小,恢复快,近期疗效良好,腹股沟疼痛、血肿等并发症明显少于经闭孔无张力阴道悬吊术(TVT-O),有较好的应用前景。

Objective To investigate the clinical efficacy and safety of Solyx^(TM)surgery in the treatment of female stress urinary incontinence(SUI).Methods From August 2020 to August 2021,female patients hospitalized in the Department of Urology of Xinyang Central Hospital were treated with Solyx^(TM)operation,and the cure rate and postoperative complications were evaluated.Results Twenty-six patients,aged 44-85 years old,with a course of 1-27 years,delivered 1-5 times,height and body mass index(BMI)19.6-26.4 kg/m^(2),abdominal leakage point pressure(ALPP)56-106 cmH_(2)O,and maximum urinary flow rate(Q_(max))22-43 mL/s were included.All 26 procedures were successful.The amount of bleeding was 5-20 mL,and the postoperative hospital stay was 2-5 days.No bladder,urethra,intestine or vagina injury,perineal hematoma or incision infection was found.After extubation,urinary incontinence disappeared and cough test was negative.One case of urinary retention cannot discharge,but urinary incontinence symptoms disappeared and urine retention was seldom found after repeated operation.No new onset of urgency occurrred.One patient with frequent urination was cured after taking tolterodine orally for 1 week.There was no recurrence of urinary incontinence during 2-12 months of follow-up period.Conclusion Solyx^(TM)surgical treatment for women with SUI has a good application prospect for its little trauma,rapid recovery,good short-term efficacy,and less inguinal pain,hematoma and other complications compared with TVT-O.