TVT-S、TVT-O、TVT-IR手术对女性压力性尿失禁的疗效及安全性比较  

Comparison on efficacy and safety of TVT-S,TVT-O and TVT-IR surgery for female stress urinary incontinence

作　　者：李潇 张凯敏[1] 李晓飞[1] Li Xiao;Zhang Kaimin;Li Xiaofei(Department of Gynecology,Luohe Maternal and Child Health Hospital(Luohe Third People's Hospital),Luohe,Henan 462300,China)

机构地区：[1]漯河市妇幼保健院(漯河市第三人民医院)妇科,河南漯河462300

出　　处：《齐齐哈尔医学院学报》2025年第3期254-258,共5页Journal of Qiqihar Medical University

基　　金：漯河医学高等专科学校2023年度科技创新项目立项(2023ZD41)。

摘　　要：目的比较经阴道无张力尿道中段吊带术(TVT-S)、经闭孔无张力尿道中段悬吊术(TVT-O)、耻骨降支无张力尿道中段悬吊术(TVT-IR)对女性压力性尿失禁(SUI)的疗效和安全性。方法回顾性分析2017年6月—2022年6月本院收治的186例女性SUI患者的临床资料,根据手术方式将其分为TVT-S组(62例)、TVT-O组(71例)和TVT-IR组(53例)三组。比较三组患者围术期相关指标;另比较三组患者术前、术后1年尿流动力学指标(功能尿道长度、最大尿道压、残余尿量)、生活质量以及术后的临床疗效和并发症发生率。结果TVT-IR组手术时间、住院时间均短于TVT-组、TVT-O组(P<0.05);与术前比较,三组术后1年功能尿道长度、最大尿道压、残余尿量均升高(P<0.05);与术前比较,三组术后1年行为受限、心理健康、社交尴尬评分以及生活质量总分均升高(P<0.05),TVT-IR组行为受限评分高于TVT-S组、TVT-O组(P<0.05),TVT-IR组生活质量总分高于TVT-S组(P<0.05)。TVT-IR组并发症发生率低于TVT-S组和TVT-O组(P<0.05)。结论TVT-S、TVT-O、TVT-IR均可有效提高女性SUI患者尿动力学功能,且均具有良好的临床效果,但TVT-IR术式相较于TVT-S、TVT-O可缩短手术时间、住院时间、提高生活质量以及降低并发症发生率。Objective To compare the efficacy and safety of tension-free vaginal tape-secure(TVT-S),tension-free vaginal tape-obturator(TVT-O)and tension-free vaginal tape-ischiopubic ramus(TVT-IR)for female stress urinary incontinence(SUI).Methods The clinical data of a total of 186 female SUI patients who were admitted to our hospital from June 2017 to June 2022 were retrospectively analyzed.According to the surgical methods,they were divided into TVT-S group(62 cases),TVT-O group(71 cases)and TVT-IR group(53 cases).The related perioperative indexes among the three groups were compared.The urodynamic indexes(functional urethral length,maximum urethral pressure,residual urine volume),quality of life before and 1 year after operation and the clinical efficacy after operation and complication rate were compared among the three groups.Results The operation time and hospitalization time of TVT-IR group were shorter than those of TVT-S group and TVT-O group(P<0.05).Compared with those before operation,the functional urethral length,maximum urethral pressure and residual urine volume of the three groups increased at 1 year after operation(P<0.05).Compared with before operation,the scores of behavior limitation,mental health,social embarrassment and total scores of quality of life in the three groups increased at 1 year after operation(P<0.05),while the score of behavior limitation in TVT-IR group was higher than that in TVT-S group and TVT-O group(P<0.05),and the total score of quality of life in TVT-IR group was higher than that in TVT-S group(P<0.05).The incidence rate of complications in TVT-IR group was lower than that in TVT-S group and TVT-O group(P<0.05).Conclusions TVT-S,TVT-O,and TVT-IR can all effectively improve urodynamic function in female SUI patients and have good clinical effects.However,the TVT-IR procedure is associated with shorter operation and hospitalization times,improved quality of life,and lower complication rates compared to TVT-S and TVT-O.

关 键 词：压力性尿失禁 经闭孔无张力尿道中段吊带术 经闭孔无张力尿道中段悬吊术 耻骨降支无张力尿道中段悬吊术 临床疗效 安全性 

分 类 号：R699.7[医药卫生—泌尿科学]