TOT治疗女性压力性尿失禁合并尿道外口狭窄的临床疗效分析  

Clinical effect of TOT on female patients with stress urinary incontinence and urinary meatus stricture

作　　者：孙双权[1] 陈立新[1] 唐春华[1] 王勇[1] 李慧[1] Sun Shuangquan;Chen Lixin;Tang Chunhua;Wang Yong;Li Hui(Department of Urology,Shanghai Songjiang District Central Hospital,Shanghai 201600,China)

机构地区：[1]上海市松江区中心医院[上海交通大学医学院附属松江医院(筹)]泌尿外科,上海201600

出　　处：《国际泌尿系统杂志》2024年第3期517-521,共5页International Journal of Urology and Nephrology

摘　　要：目的:探讨女性压力性尿失禁(SUI)合并尿道外口狭窄患者的尿动力学特征及经闭孔尿道中段悬吊术(TOT)治疗的临床疗效。方法:回顾性分析2018年1月至2021年12月在本院行TOT手术治疗的52例女性SUI患者的尿动力学检查结果及临床资料。将患者分为SUI合并尿道外口狭窄组(UMS组,14例)和SUI不合并尿道外口狭窄组(WUMS组,38例),对比分析两组患者的尿动力学特征。评估TOT手术对两组患者的临床疗效。结果:两组患者的临床症状,如尿频、尿急、排尿费力及尿路感染的发生率比较,差异均无统计学意义(均P>0.05)。自由状态下UMS组患者的最大尿流率(Q_(max))及平均尿流率(Q ave)明显低于WUMS组,差异均有统计学意义(均P<0.05);UMS组的排尿达峰时间(TQ_(max))、TQ_(max)/排尿时间(VT)比值明显小于WUMS组,差异均有统计学意义(均P<0.05)。UMS组患者Q_(max)时的逼尿肌压力明显高于WUMS组,Q_(max)明显低于WUMS组,差异均有统计学意义(均P<0.001)。两组手术前及术后2周的Q_(max)比较,差异均无统计学意义(均P>0.05);两组术后2周的ICI-Q-SF评分均较术前明显下降,差异均有统计学意义(均P<0.05)。两组术前及术后2周的ICI-Q-SF评分比较,差异均无统计学意义(均P>0.05)。结论:女性SUI合并尿道外口狭窄患者的Q_(max)低于无尿道外口狭窄的SUI患者,但其不是TOT手术的禁忌证,TOT手术效果良好,并不会增加患者术后尿潴留或排尿困难的风险。Objective To investigate the urodynamic characteristics of female stress urinary incontinence with urinary meatus stricture(UMS)and the clinical effect of trans-obturator vaginal tape(TOT)surgery.Methods The urodynamic examination and clinical data of 52 female patients with SUI who underwent TOT surgery in the hospital from January 2018 to December 2021 were retrospectively analyzed.The patients were divided into two groups:SUI with UMS(UMS group,14 cases)and SUI without UMS(WUMS group,38 cases).The urodynamic results of the two groups were compared and analyzed.Before and 2 weeks after TOT operation,the effect of TOT operation on SUI patients in UMS and WUMS groups was evaluated.Results There were no significant difference between the two groups in the incidence of clinical symptoms,such as frequency of urination,urgency,laborious urination and urinary tract infection(all P>0.05).The maximum urine flow rate(Q_(max))and average urine flow rate(Q_(max))in UMS group were significantly lower than that in WUMS group before operation,and the differences were statistically significant(all P<0.05).The peaking time of urination in UMS group was significantly lower than that in WUMS group,and the TQ_(max)/VT ratio was significantly lower than that in WUMS group,with statistical significance(all P<0.05).The pressure of detrusor at maximum quantity of urine of patients in UMS group was significantly higher than that in WUMS group,and the Q_(max)in UMS group was significantly lower than that in WUMS group,and the differences were statistically significant(all P<0.001).The Q_(max)of patients in the two groups did not decrease significantly before and 2 weeks after operation,and the difference was not statistically significant(all P>0.05).The ICI-Q-SF scores of both groups were significantly decreased 2 weeks after surgery compared with those before surgery,with statistical significance(all P<0.05).There was no significant difference in ICI-Q-SF scores before and 2 weeks after surgery between the two groups(all P>0.05).Conclu

关 键 词：尿失禁 压力性 尿道外口狭窄 尿道下悬吊术 

分 类 号：R711.59[医药卫生—妇产科学]