改良TVT-O术治疗中重度女性压力性尿失禁的长期随访  

Long-term efficacy of tension-free vaginal tape-obturator in treatment of female moderate or severe stress urinary incontinence

作　　者：赵勇锋[1] 章劲夫[2] 夏红[1] 李怀芳[1] 童晓文[1] 

机构地区：[1]同济大学附属同济医院妇产科,上海200065 [2]同济大学附属同济医院泌尿外科,上海200065

出　　处：《同济大学学报（医学版）》2013年第6期45-48,共4页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金(30471815)

摘　　要：目的观察改良的经闭孔无张力吊带尿道中段悬吊术（modified tension-flee vaginal tape-obturator,改良TVT—O术）治疗女性中重度单纯性压力性尿失禁（stress urinary incontinence, SUI）的长期疗效。方法收集同济大学附属同济医院妇产科2005年3月～2006年12月收治的58例女性中重度单纯性SUI患者行改良TVT—O手术的临床资料，回顾分析并进行术后1、3、6、12个月及每年定期随访，观察手术治疗的短期及长期治疗效果及并发症。结果58例女性中重度单纯性SUI进行改良TVT—O手术的患者中，1年随访时均治愈或好转、未出现无效或复发，2年随访时失访3例（5．17％）、复发3例，复发者均行再次手术，术后症状均逐步好转，3年随访时1例高龄患者死亡，其余病例3年及以后每年随访均未复发，治愈46例（79．31％），好转8例（13．79％），其中4例出现了急迫性尿失禁的表现，经药物治疗又有所好转。结论改良TVT-O术治疗女性中重度单纯性SUI，手术操作简便、用时短、出血少，经短期及长期随访治愈好转率高，疗效均可靠。Objective To evaluate the long-term efficacy of modified tension-free vaginal tape- obturator （modified TVT-O） in treatment of moderate and severe female stress urinary incontinence （SUI）. Methods Fifty-eight patients with simple moderate and severe SUI were treated with modified TVT-O in Tongji Hospital from March 2005 to December 2006. Patients were followed-up at 1, 3, 6, 12 month postoperatively and annually after then, the surgical efficacy and complications were analyzed. Results During the first year of follow-up all patients were cured or improved and there were no recurrence or invalid treatment. In the second year 3 cases （5.17%） were lost in follow-up, and SUI was recurrent in 3 out of 55 patients, who received re-operation and symptoms were improved. In the third year of follow-up no more recurrence was observed except one case oleo. The overall cure and improve rate was 79. 31% （46/58） and 13. 79% （8/58）, respectively. Conclusion Both the short and long-term efficacy of the modified TVT-O is satisfactory in treatment of female moderate and severe SUI.

关 键 词：经闭孔无张力吊带尿道中段悬吊术 女性 中重度压力性尿失禁 长期随访 

分 类 号：R713.43[医药卫生—妇产科学]