经会阴超声评估压力性尿失禁患者无张力尿道中段悬吊术后吊带位置及并发症的应用价值  

The Application V alue of Transperineal Ultrasonography to Evaluate the Position of Sling and the Complications After Tension Free V aginal Tape Obturator in Patients with Stress Urinary Incontinence

作　　者：陈珂 余珊珊 麻妙艳 孙露 周琦[1] Chen Ke;Yu Shanshan;Ma Miaoyan;Sun Lu;Zhou Qi(Department of Medical Ultrasonic,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学医学部第二附属医院医用超声研究室,西安市710004

出　　处：《中国超声医学杂志》2024年第8期917-920,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 运用经会阴超声评估压力性尿失禁(SUI)患者经闭孔阴道无张力尿道中段悬吊术(TVT-O)后吊带位置及形态与并发症之间的关系。方法 对65例行TVT-O术的SUI患者在术后1年进行经会阴超声检查,观察静息及Valsalva状态下吊带位置及角度,随访收集术后并发症的相关信息,包括排尿功能障碍、复发SUI、会阴部疼痛及反复尿路感染等,分析发生与不发生相关并发症患者的吊带位置是否存在差异。结果 术后出现排尿功能障碍的患者,Valsalva状态下吊带夹角、吊带距尿道腔的距离均小于未出现该症状的患者(123.41±16.63 vs. 146.52±12.41,P=0.037;3.02±0.31 vs. 4.21±0.41,P=0.041);术后反复尿路感染的患者与未出现该并发症的患者相比,静息及Valsalva状态下吊带更靠近尿道外口(静息状态0.75±0.04 vs. 0.66±0.07,P=0.008;Valsalva状态0.74±0.04 vs. 0.69±0.07,P=0.035);术后复发SUI的患者,Valsalva状态下吊带距尿道腔的距离更远(5.23±0.28 vs. 4.21±0.41,P=0.043)。结论 经会阴超声能够观察SUI患者TVT-O术后吊带的精确位置,为术后并发症的评估提供影像依据。Objective To evaluate the relationship between the position and shape of sling and postoperative complications after tension free vaginal tape obturator(TVT-O)surgery in patients with stress urinary incontinence(SUI)by transperineal high frequency ultrasound combined with three-dimensional pelvic floor ultrasound.Methods A total of 65 patients with SUI who underwent TVT-O had transperineal high frequency ultrasound and three-dimensional pelvic floor ultrasound examination one year after surgery,the position and angle of the sling under rest and Valsalva maneuver were observed.The postoperative complication information including urinary dysfunction,recurrent SUI,perineal pain and recurrent urinary tract infection were collected by follow-up.The difference of sling position between patients with and without complications was analyzed.Results The angle of the sling and the distance of sling tourethral cavity under Valsalva maneuver in patients with urinary dysfunction were smaller than those patients without(123.41±16.63vs.146.52±12.41,P=0,037;3.02±031vs.4.21±0.41,P=0.041).Comparewith the patients without,the strap in patients with recurrent urinary tract infection after surgery was closer to the external orifice of urethra in resting and Valsalva maneuver(resting 0.75±0.04 vs.0.66±0.07,P=0.008;Valsalva maneuver 0.74±0.04 vs.0.69±0.07,P=0.035).In patients with recurrent SUI after surgery,the distance of sling to urethral lumen in patients without was longer in Valsalva maneuver(5.23±0.28 vs.4.21±0.41,P=0.043).Conclusions Transperineal high frequency ultrasound combined with three-dimensional pelvic floor ultrasound can effectively observe the exact position of the sling after TVT-O in SUI patients,and may provide imaging basis for the postoperative complications evaluation.

关 键 词：压力性尿失禁 经闭孔阴道无张力尿道中段悬吊术 并发症 吊带位置 

分 类 号：R713[医药卫生—妇产科学] R445.1[医药卫生—临床医学]