采用尿动力学评估TVT-O治疗SUI术后近期疗效  

Evaluated the Short Time Effect of TVT-O for Female Stress Urinary Incontinence by Urodynamic

作　　者：文建国[1,2] 张艳[1] 娄安锋[1] 芦山[1] 陈燕[1] 张国贤[1,2] 胡金华[1] 毛淑平[1] 

机构地区：[1]郑州大学第一附属医院尿动力学中心泌尿外科,郑州450052 [2]河南省高等学校临床医学重点学科开放实验室

出　　处：《临床泌尿外科杂志》2010年第12期899-901,905,共4页Journal of Clinical Urology

基　　金：河南省医学科技攻关计划资助项目(编号200801002);郑州市技术研究与开发经费支持项目(编号074SGHH32262)

摘　　要：目的:探讨采用尿动力学检查评估经闭孔尿道中段无张力悬吊术(TVT-O)治疗女性压力性尿失禁(SUI)近期疗效的作用。方法:选取经TVT-O治疗的女性SUI患者50例,平均年龄(55.1±7.53)岁。全部患者术前和随访时填写国际尿失禁咨询委员会问卷简表(ICI-Q-sF)并行尿动力学检查.比较手术前和随访时各参数的变化。结果:成功随访33例,平均随访12.7个月。与术前相关指标比较,术后ICI-Q-sF评分和最大尿流率显著低于术前[术后(0.2±0.1)vs术前(14.6±3.2),术后(26.4±5.5)ml/s vs术前(30.6±8.1)ml/s,P<0.05];而术后剩余尿量、最大逼尿肌收缩压、初始尿意、最大膀胱测压容量、膀胱顺应性、最大尿道压、最大尿道闭合压和功能性尿道长度没有显著性改变(P>0.05)。术中无膀胱及尿道损伤,无闭孔血管神经损伤,无阴道肠管穿孔及血肿等并发症发生;术后并发排尿困难1例(3%)、腹股沟不适2例(6%)及尿急尿频1例(3%),经对症治疗后好转。手术治愈率和改善率分别为85%(28/33)和12%(4/33)。结论:采用TVT-O治疗女性SUI患者近期效果较好,尿动力学检查是其诊断和疗效评估的有效手段。Objective：To evaluate the short time effect of transobturator vaginal tape Inside-out（TVT-O） for female stress urinary incontinence（SUI） by urodynamic examination. Methods：Fifty women （55.1±7.53 y） with SUI who underwent TVT-O were randomly selected. Before treatment, the score of international continence in- quiring committees questionnaire（ICI-Q-sF） and urodynamics evaluation were performed, as well as follow-up. The pre-operation parameters were compared with those of follow-up. Results：The mean follow-up period was 12. 7 months and 33 cases were successfully enrolled in the study. Compared with pre-operation, ICI-Q-sF and maxi- mum flow rate were significantly reduced in follow-upE（0. 2±0. 1） vs （14. 6±3.2） ,（26.4±5.5） ml/s vs （30. 6± 8. 1） ml/s,P〈0. 05]; In contrast, there were no statistical differences in postvoid residual volume, max detrusor pressure, first desire, maximum cystometric capacity, bladder compliance, maximum urethral pressure, maximum urethral closure pressure and static functional length（P〉0. 05）. Intraoperative injury to bladder and urethra, and obturator nerve injury, intestinal perforation, hematoma were not found;Complications included one（30% ） voiding difficulty, two（6%） groin pain and one（3%） de novo urge urinary incontinence, which were improved after symp- tomatic treatment. The overall cure rate was 85 % （28 of 33 patients） and 12 % （4 of 33 patients） had improvement of symptoms. Conclusions： The TVT-O procedure is an efficient treatment of female SUI. Urodynamic study can provide a good means to diagnose and evaluate it.

关 键 词：女性压力性尿失禁 经闭孔尿道中段无张力悬吊术 尿动力学 

分 类 号：R694[医药卫生—泌尿科学]