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目的分析经闭孔无张力尿道中段悬吊术(TVT-O)治疗女性压力性尿失禁(SUI)的临床疗效。方法回顾性分析38例用TVT-O治疗的女性SUI的临床资料。结果38例患者术后随访15±3.9月(2～20月),均临床治愈,无SUI复发,完全改善率92.1%(35/38),症状显著好转率7.9%(3/35)。术中无膀胱、闭孔血管神经等损伤;术后3例暂时性排尿困难,尿道扩张并膀胱锻炼后缓解;23例患者术后6月尿流动力学检测显示,平均尿流率(Qave)及最大尿道闭合压(MUCP)明显回复,而其他指标无明显变化;2例患者于术后3周尿失禁复发,术后8周行尿流动力学检查,并以此分别对2例患者进行吊带调整及Burch阴道壁悬吊术,术后未复发。结论TVT-O操作简单、微创、并发症少,是治疗女性压力性尿失禁安全有效的方法。
Objective To analyze the clinical effect of transthoracic tension-free urethral suspension (TVT-O) in the treatment of female stress urinary incontinence (SUI). Methods The clinical data of 38 SUI patients treated with TVT-O were retrospectively analyzed. Results 38 patients were followed up 15 ± 3. 9 months (2 ~ 20 months), were clinically cured, no SUI recurrence, the complete improvement rate was 92.1% (35/38), the symptoms significantly improved rate of 7.9% (3/35). There were no bladder and obturator neurovascular injury during operation; 3 patients had temporary dysuria, urethral dilatation and bladder remission after operation; urodynamics in 23 patients showed that the mean flow rate (Qave) and The maximal urethral closure pressure (MUCP) returned significantly, while no significant changes were observed in other indexes. Two patients recurred urinary incontinence 3 weeks after operation and urodynamics 8 weeks after operation. And Burch vaginal wall suspension, did not relapse after surgery. Conclusion TVT-O is simple, minimally invasive and has few complications. It is a safe and effective method to treat female stress urinary incontinence.