两种经闭孔无张力尿道悬吊术治疗压力性尿失禁疗效对比研究  

Comparison of the efficacy and safety of TOT and TVT-O on stress incontinence

作　　者：王凤玫[1] 宋健[1] 宋岩峰[1] 

机构地区：[1]南京军区福州总医院妇产科,350025

出　　处：《中国妇产科临床杂志》2009年第1期16-18,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：福建省青年人才资助项目(2008F3087)资助

摘　　要：目的回顾性评估由外向内经闭孔无张力尿道悬吊术('outside-in'transobturator tape,TOT)与由内向外经闭孔无张力尿道悬吊术('inside-out'transobturator tape,TVT-O)治疗压力性尿失禁的安全性和有效性。方法选择2004年4月～2007年1月本院压力性尿失禁患者79例,其中,行TOT患者41例,行TVT-O患者38例。TOT组和TVT-O组患有混合性尿失禁者分别为17例和13例;伴有盆腔脏器脱垂者9例和7例。对比两种手术方式的治愈率和术后并发症,评估两者的安全性和有效性。结果单纯性尿失禁患者平均手术时间为11min(TOT)和15min(TVT-O)。TVT-O组发生膀胱穿孔1例。TOT组平均随访时间为26个月,TVT-O组为14个月。TVT-O组和TOT组的1年总治愈率分别为92%和90%(P>0.05)。结论TOT和TVT-O均能有效的治疗伴有或不伴有盆腔器官脱垂的压力性尿失禁。Objective We retrospectively assess the efficacy and safety of outside- in transobturator tape （TOT） and inside- out transobturator tape （TVT- O） for female stress urinary incontinence. Method A nonrandomized, retrospective, observational, monocentric study of 79 female patients （41 in TOT and 38 in TVT- O） was conducted to assess the efficacy and safety of the two surgical procedures for female stress urinary incontinence from April 2004 to January 2007. All the patients presented with stress urinary incontinence except that 17 patients in TOT group and 13 in TVT - O group presented with mixed urinary incontinence. Beside the procedures for urina- ry incontinence, 7 in TVT- O group and 9 in the TOT group received concomitant pelvic reconstructive procedures. The effect of the procedures and complications were followed up in all patients at a range of 1 month to 36 months. Results Mean operative time was 11 minutes for the patients undergoing TOT alone and 15 minutes for the patients undergoing TVT- O alone. The only peri - operative complication was a bladder perforation for a patient in the TVT- O groups. No injury to obturator nerves or vessels occurred during the needle passing via the tranobturator route. Mean follow - up time was 26 months for TOT and 14 months for TVT- O group. Overall, the recovery rate was 92% at 1 year follow- up for TVT-O group and 90~ for TOT group （p=NS）. No vaginal erosion was found in our study. Conclusion The study shows that the two trans - obturator assess routes are equally safe and efficacy in treatment of female stress urinary incontinence, alone or in combination with prolapse repair.

关 键 词：尿失禁 尿道中段悬吊术 安全性 有效性 

分 类 号：R699[医药卫生—泌尿科学]