无张力尿道悬吊改良术与尿道中段悬吊带术治疗女性压力性尿失禁的临床观察  

A comparative study on treating femal stress urinary incontinence with TVT-Abbrevo and TVT- Obturator

作　　者：李卫林[1] 卢子文[1] 李飞平[1] 俞洪元[1] 

机构地区：[1]温州医科大学附属台州医院泌尿外科,浙江省临海市317000

出　　处：《中华医学杂志》2016年第28期2238-2240,共3页National Medical Journal of China

摘　　要：目的观察并比较经闭孔无张力尿道悬吊改良术（TVT－Abbrevo）与无张力尿道中段悬吊带术（TVT－O）治疗女性压力性尿失禁的疗效。方法选取温州医科大学附属台州医院2012年11月至2013年11月收治的女性压力性尿失禁患者117例，行TVT－Abbrevo术79例，行TVT－O术38例，观察手术效果及并发症。结果117例中，107例患者尿失禁症状完全消失，10例好转，其中TVT－Abbrevo组治愈72例（91.1%），好转7例（8.9%）；TVT－O组治愈35例（92.1%），好转3例（7.9%）；两组的治愈率比较差异无统计学意义（P〉0.05）。术后24 h及术后1周TVT－Abbrevo组发生大腿内侧疼痛的例数低于TVT－O组，两组在术后24 h及术后1周的疼痛发生率比较差异均有统计学意义（均P〈0.05）；术后1个月及术后1年TVT－Abbrevo组疼痛发生率与TVT－Obturator组比较，差异无统计学意义（P〉0.05）。两组手术术中均无血管、神经、膀胱损伤，术后均无耻骨后血肿、吊带腐蚀等其他并发症发生。随访1年，均无复发。结论TVT－Abbrevo与TVT－O手术方法及疗效相当，均是治疗女性压力性尿失禁患者的有效方法；TVT－Abbrevo术式可降低患者术后近期的大腿内侧疼痛发生率。Objective To compare the effectiveness and complications of TVT-Abbrevo （ tension- free vaginal tape-Abbrevo） and TVT-Obturator （tension-free vaginal tape-obturator） for the treatment of female stress urinary incontinence （SUI）. Methods From Nov. 2012 to Nov. 2013, 117 patients suffering from SUI were treated with TVT-Abbrebo （ n = 79 ） or TVT-Obturator （ n = 38 ） procedure, the clinical efficacy and operation-correlated complications were observed. Results A total of 117 cases, 107 cases of urinary incontinence symptoms disappeared completely, 10 cases were improved. 72 cases （91.1%） were cured and 7 cases （8.9%） were improved in TVT-Abbrevo group; 35 cases （92. 1% ） were cured and 3 cases （7.9%） were improved in TVT-Obturator group. No significant differences could be found for the curing rates between two groups （ P 〉 0. 05 ）. Compared with the TVT-Obturator group, the TVT-Abbrevo group had less patients complaining of inner thigh pain at 24 h and 1 w after surgery （ P 〈 0. 05 ）. No significant differences were observed for the incidence of inner thigh pain at 1 m and 1 y after surgery between TVT-Abbrevo and TVT-Obturator group （ P 〉 0. 05 ）. No intraoperative complications such as blood vessel, nerve, bladder damage were recorded and no postoperative retropubic hematoma, tape adjustment and other complications occurred in two goups. No recurrence after 1 year follow-up. Conclusions The study shows that TVT-Abbrevo procedure is safe and efficacy in treatment of SUI, and associated with low incidence of recent postoperative inner thigh pain.

关 键 词：女性压力性尿失禁 TVT—Abbrevo TVT—Obturator 

分 类 号：R699.7[医药卫生—泌尿科学]