摘要
目的 对比观察经耻骨后径路无张力阴道吊带术（TVT）和经闭孔径路无张力阴道吊带术（TVT-O）治疗女性压力性尿失禁（SUI）的效果.方法 2002年6月至2005年5月,行女性SUI无张力阴道吊带术81例.患者年龄35～79岁,平均51岁.病程 6个月～30年.其中行TVT58例、行TVT-O术者23例.以术后增加腹压有无尿液溢出为疗效判断标准.结果 TVT组TVT-O组手术时间分别为30～60 min[平均（36.4±7.6）min]、20～35 min[平均（24.4±5.1）min]（P＜0.01）.81例中,74例（91.4%）尿失禁症状完全消失,5例（6.2%）改善,2例（2.5%）失败.TVT组治愈52例（89.7%）、改善4例（6.9%）、失败2例（3.4%）;TVT-O组治愈22例（95.7%）、改善1例（4.3%）;2组比较差异无统计学意义（P＞0.05）.TVT组和TVT-O组分别有6例（10.3%）和2例（8.7%）发生术后排尿困难;TVT组3例（5.2%）术中发生膀胱损伤,1例（1.7%）术后发生耻骨后血肿;TVT-O组3例（13.0%）术后2 d内出现双下肢短暂性活动障碍自行缓解.结论 无张力阴道吊带术是一种治疗女性SUI安全有效的方法,TVT-O较TVT更为简单,创伤更小,并发症轻.
Objective To prospectively compare tension-free vaginal tape （TVT） with transobturatot inslde-out tension-free urethral suspension （TVT-O） for the surgical treatment of female stress urinary incontinence （SUI）. Methods Eighty-one women Cage range,35 -79 years;mean age,51 years） with SUI were assigned to undergo either TVT （ n = 58） or TVT-O （ n = 23） surgery between June 2002 and May 2005. Their disease course ranged from 6 months to 30 years. Therapeutic effect was assessed by presence or absence of incontinence when abdominal pressure increased. Results The mean operative time in TVT group [ 30 - 60 rain, mean （36.4 ± 7.6） mini was significantly longer than in TVT-O group （ 20 - 35 min, mean （ 24.4 ± 5.1 ） rain ;P 〈 0.01 ）. Of the 81 patients,74 （ 91.4% ） were cured, 5 （ 6.2% ） had improvement,and 2 （2.5%） failed to respond to the procedure. The rates of cure, improvement and failure were 89.7% （52 cases） ,6.9% （4） and 3.4% （2） in TVT group,and were 95.7% （22）,4.3% （1） and0, respectively in TVT-O group（ P 〉 0.05 ）. The rate of postoperative urinary retention was 10.3% （6 cases） in TVT group vs 8.7% （2） in TVT-O group. No bladder injury occurred in TVT-O group vs 5.2% （3 cases） in TVT group. One patient（ 1.7% ） had retropubic hematoma in TVT group, and 3 （ 13.0% ） had transient dysfunction of both lower limbs postoperatively in TVT-O group. Conclusions The tension-free urethral suspensions are highly effective and safe for the treatment of SUI in women. Compared with TVT,TVT-O is simpler, less invasive and has fewer complications.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2006年第5期321-323,共3页
Chinese Journal of Urology
关键词
尿失禁
压力性
无张力阴道吊带
Urinary incontinence,stress
Tension-free vaginal tape
