无张力阴道吊带术治疗女性压力性尿失禁(附13例报告)

Treatment of female stress urinary incontinence with tension-free vaginal tape (report of 13 cases)

目的 评价无张力阴道吊带术 (TVT)治疗女性压力性尿失禁疗效。 方法 女性压力性尿失禁患者 13例 ,经临床和尿动力学检查确诊 ,均为稳定性膀胱 ,膀胱出口无梗阻。采用Prolene聚丙烯网状吊带 ,手术自阴道前壁切口经耻骨后向下腹部穿刺 ,将吊带无张力置于尿道中段。 结果 手术时间平均 (38± 7)min ;术中出血量平均 (4 5± 10 )ml;术后平均留置导尿 2d ;术后平均住院 4d。13例患者术后尿失禁症状均消失。 1例患者术后出现尿潴留 ,留置导尿 2周后无改善 ,予手术切断吊带 ,尿潴留症状消失 ,尿失禁未复发。 结论 TVT手术疗效确切 ,操作简便 ,对患者损伤小 ,并发症发生率低 ,是一种治疗女性压力性尿失禁的有效方法。

Objective To evaluate the outcome of a new modality of operation—tensionfree vaginal tape (TVT) in treatment of female stress urinary incontinence. Methods Thirteen female patients suffering from stress urinary incontinence were treating with TVT operation.All the patients were confirmed to have stable bladder without outlet obstruction via clinical routine and urodynamic examination before operation.TVT tape of Prolene was implanted around mid-urethra via a minimal vaginal incision. Results The mean operation time was (38±7)min and the mean intraoperative bleeding was (45±10)ml.The mean catheterization time was 2 days and mean hospital stay was 4 days.No major bleeding was observed in operation.All patients were cured and the clinical symptoms disappeared after operation except for one patient with post-operative urine retention.This patient was catheterized for 2 weeks and the tape was cut under local anesthesia;then the urine retention disappeared and no incontinence relapsed. Conclusions TVT is a simple,reliable mini-invasive procedure with low incidence of complications.It can be used routinely for treating female stress urinary incontinence.