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目的:观察同期手术治疗女性压力性尿失禁(SUI)合并阴道前壁脱垂的临床疗效。方法:回顾性分析27例SUI合并阴道前壁脱垂(Ⅱ、Ⅲ)患者同期行经闭孔无张力尿道中段吊带术(TVT-O)和阴道前壁修补术的临床资料。结果:所有患者均顺利完成手术。术后随访12个月,尿失禁治愈25例,症状改善2例,总有效率100%。阴道前壁脱垂治愈23例,改善4例(仍存在Ⅰ度脱垂),总有效率100%。27例患者手术前后的ICI-QSF评分分别为(15.08±2.54)分和(0.26±0.05)分,19例有性生活的手术前后PISQ-12评分分别为(24.23±3.80)分和(27.49±4.19)分,手术前后比较,差异均有统计学意义(P<0.01)。5例患者术后早期有股部疼痛,对症处理后消失;无长期疼痛、吊带侵蚀、感染、瘘管等并发症。结论:TVT-O联合阴道前壁修补术治疗SUI合并阴道前壁脱垂(Ⅱ、Ⅲ)者效果满意,并发症少,值得临床推广应用。
Objective: To observe the clinical efficacy of simultaneous surgical treatment of female stress urinary incontinence (SUI) with vaginal anterior wall prolapse. Methods: The clinical data of 27 cases of SUI combined with anterior vaginal wall prolapse (Ⅱ, Ⅲ) were retrospectively analyzed. The data of TVT-O and anterior vaginal wall repair were retrospectively analyzed. Results: All patients successfully completed the operation. After 12 months of follow-up, incontinence was cured in 25 cases, the symptoms improved in 2 cases, the total effective rate was 100%. Anterior vaginal wall prolapse cured 23 cases, improved in 4 cases (there is still Ⅰ degree prolapse), the total effective rate of 100%. ICI-QSF scores were (15.08 ± 2.54) and (0.26 ± 0.05) before and after operation in 27 patients, PISQ-12 scores were (24.23 ± 3.80) and (27.49 ± 4.19) points before and after surgery, the differences were statistically significant (P <0.01). In 5 cases, there was pain in the femoral head early after operation and disappeared after symptomatic treatment. There were no complications such as long-term pain, sling erosion, infection and fistula. Conclusion: TVT-O combined with anterior vaginal wall repair for SUI with vaginal anterior wall prolapse (Ⅱ, Ⅲ) were satisfactory results, fewer complications, it is worthy of clinical application.