两种手术方法治疗女性压力性尿失禁伴阴道前壁膨出的疗效比较  

Comparison of the efficacy of two surgery methods on female stress urinary incontinence with anterior vaginal prolapse

作　　者：于洪波[1] 沈华[1] 吴宏飞[1] 周鹤同[1] 廖凯[1] 张斌[1] 林建中[1] 李久明[1] 

机构地区：[1]南京明基医院泌尿外科,南京医科大学附属医院,南京210019

出　　处：《临床泌尿外科杂志》2012年第10期764-766,共3页Journal of Clinical Urology

摘　　要：目的:比较经闭孔无张力阴道吊带术(TVT-O)和TVT-O加阴道前壁修补术两种手术方法治疗女性压力性尿失禁(SUI)合并阴道前壁膨出的疗效。方法:86例SUI合并阴道前壁膨出患者,随机分为TVT-O手术组(40例)和TVT-O加阴道前壁修补手术组(46例)。术后随访时间6～36个月,按照阴道前壁膨出分度分别进行疗效判定。采用PASW 18.0统计软件分析。结果:TVT-O治疗组的SUI治愈率为52.5%,TVT-O加阴道前壁修补组治愈率为93.5%,两种手术方法疗效差异有统计学意义(P<0.05)。合并Ⅰ度阴道前壁膨出者,做或不做阴道前壁修补,疗效差异无统计学意义(P>0.05);合并Ⅱ～Ⅲ度阴道前壁膨出者,TVT-O加阴道前壁修补组效果显著优于单纯TVT-O治疗组(P<0.05)。结论:对于SUI合并Ⅱ度以上阴道前壁膨出者,单纯TVT-O治疗效果欠佳,应同时行阴道前壁修补术。Objective： To comparison the efficacy of tension-free vaginal tape-obturator（TVT-O）and TVT-O with anterior vaginal repair on treating female stress urinary incontinence with anterior vaginal prolapse. Method.. Eighty-six patients diagnosed as stress urinary incontinence with anterior vaginal prolapse were randomly divided into two groups. 40 cases were treated with TVT-O,and another 46 cases were treated with TVT-O and anterior vaginal repair. Follow-up time after operation ranged from 6 to 36 months,and the curative effects were assessed according to the degree of anterior vaginal prolapse. PASW 18.0 was used for statistical analysis. Result：The cure rate of TVT-O and TVT-O with anterior vaginal repair on SUI was 52.5% and 93, 5%, respectively. There was significant difference between the two groups（P〈0.05）. No significant difference was observed in cases with I° anterior vaginal prolapse（P〉0.05）. While in patients with II °to III ° anterior vaginal prolapse, the efficacy of TVT-O with anterior vaginal repair was significantly superior than simple TVT-O （P 〈 0.05）. Conclusion： The therapeutic efficacy of simple TVT-O was below the mark for patients of stress urinary incontinence with II °to III ° anterior vaginal prolapse,and anterior vaginal repair should be done simultaneously.

关 键 词：压力性尿失禁 阴道前壁膨出 经闭孔无张力阴道吊带术 阴道前壁修补术 

分 类 号：R694[医药卫生—泌尿科学]