阴道无张力尿道中段悬吊术治疗女性尿失禁的临床观察  

Clinical observation of tension-free vagina l tape procedure as a new surgical treatment method for female urinary incontine nce

作　　者：罗新[1] 

机构地区：[1]暨南大学附属第一医院妇产科,广州510630

出　　处：《中华妇产科杂志》2004年第11期741-743,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨阴道无张力尿道中段悬吊术 (tension freevaginaltape ,TVT)治疗女性尿失禁的临床效果。方法　回顾性分析自 2 0 0 1年 5月至 2 0 0 3年 2月 ,应用TVT手术治疗的 2 3例 (其中18例为压力性尿失禁 ,5例为混合性尿失禁 )女性尿失禁患者的临床资料。结果　 2 3例TVT手术中 ,除 1例因术中可疑有损伤而改为尿道折叠 (Kelly)术外 ,其余TVT手术均成功 ,手术成功率为96 % (2 2 / 2 3)。 2 0例 (91% )术后排尿功能恢复良好 ,2例 (9% )分别因膀胱不稳定 (运动型急迫性尿失禁 )及感染而发生排尿困难 ,经持续导尿、膀胱训练及药物治疗后 ,均恢复正常排尿功能。平均手术时间为 4 9min。术后两年随访所有患者 ,排尿功能均恢复正常。结论　TVT手术简单、微创、恢复快、效果好。Objective To study the clinical effect of tension-free vaginal tape (TVT) procedure as a new surgical treatment method for female urinary incontinence. Methods The outcome of 23 TVT procedures for female urinary incontinence was retrospecti vely analyzed from May 2001 to Feb 2003. Results Out of the 23 cases recruited into this study, 18 (78%) had stress urinary incon tinence (SUI), and 5 (22%) had SUI with mixed motorurge urinary incontinence (MU I). One (4%) case was changed to Kelly′s operation intraoperatively. The success rate of TVT was 96% (22/23). Twenty (91%) of the 22 women were comple tely cured without any complications. Two patients had dysuria caused by MUI a nd infection, respectively, and recovered after bladder catheterization, and exe rcising bladder and medication therapy. The average time of TVT procedure was 49 min. The cure rate was 100%. Conclusions The TVT procedure is a simple, safe and effec tive, minimally invasive operation for female SUI. Prevention and control of in fection, and proper adjustment of TVT tension are the keys to avoid urinary ret ention after operation. SUI with MUI is not an absolute contraindication for TV T.

关 键 词：治疗 TVT手术 女性尿失禁 尿道 排尿功能 悬吊术 无张力 折叠 恢复 膀胱 

分 类 号：R713[医药卫生—妇产科学]