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目的:探讨采用尿动力学检查评估经闭孔尿道中段无张力悬吊术(TVT-O)治疗女性压力性尿失禁(SUI)近期疗效的作用。方法:选取经TVT-O治疗的女性SUI患者50例,平均年龄(55.1±7.53)岁。全部患者术前和随访时填写国际尿失禁咨询委员会问卷简表(ICI-Q-sF)并行尿动力学检查.比较手术前和随访时各参数的变化。结果:成功随访33例,平均随访12.7个月。与术前相关指标比较,术后ICI-Q-sF评分和最大尿流率显著低于术前[术后(0.2±0.1)vs术前(14.6±3.2),术后(26.4±5.5)ml/s vs术前(30.6±8.1)ml/s,P<0.05];而术后剩余尿量、最大逼尿肌收缩压、初始尿意、最大膀胱测压容量、膀胱顺应性、最大尿道压、最大尿道闭合压和功能性尿道长度没有显著性改变(P>0.05)。术中无膀胱及尿道损伤,无闭孔血管神经损伤,无阴道肠管穿孔及血肿等并发症发生;术后并发排尿困难1例(3%)、腹股沟不适2例(6%)及尿急尿频1例(3%),经对症治疗后好转。手术治愈率和改善率分别为85%(28/33)和12%(4/33)。结论:采用TVT-O治疗女性SUI患者近期效果较好,尿动力学检查是其诊断和疗效评估的有效手段。
OBJECTIVE: To investigate the effect of urodynamic examination on the short-term efficacy of transthoracic urethral tension-free suspension (TVT-O) in the treatment of female stress urinary incontinence (SUI). Methods: Fifty female SUI patients treated with TVT-O were selected, with a mean age of (55.1 ± 7.53) years. All patients underwent preoperative and follow-up ICI-Q-sF parallel urodynamic examinations were performed to compare the changes of parameters before and during follow-up. Results: A total of 33 cases were successfully followed up for an average of 12.7 months. Compared with preoperative indicators, the postoperative ICI-Q-sF score and the maximum uroflow rate were significantly lower than those before operation [postoperative (0.2 ± 0.1) vs preoperative (14.6 ± 3.2), postoperative (26.4 ± 5.5) ml / s vs preoperative (30.6 ± 8.1) ml / s, P <0.05]; while postoperative residual urine volume, maximal detrusor systolic pressure, initial urinary incontinence, maximal bladder pressure measurement, bladder compliance, maximal urethral pressure, The maximum urethral closure pressure and functional urethral length did not change significantly (P> 0.05). There was no bladder and urethral injury, no obturator neurovascular injury, no vaginal bowel perforation and hematoma and other complications. Postoperative dysuria occurred in 1 case (3%), groin discomfort in 2 cases (6%) and urgency and urinary frequency 1 case (3%), after symptomatic treatment improved. The cure rate and improvement rate were 85% (28/33) and 12% (4/33) respectively. Conclusion: TVT-O treatment of female patients with SUI better results in recent times, urodynamic examination is an effective means of diagnosis and efficacy evaluation.