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目的 分析应用阴道无张力尿道悬吊带(TVT)术、经闭孔尿道悬吊带(TOT)术、自体阔筋膜尿道悬吊(Lata)术,以及耻骨后库柏韧带悬吊(Burch)术治疗压力性尿失禁(SUI)术的临床效果。方法 回顾分析103例尿失禁并部分合并子宫、阴道脱垂患者行不同手术治疗的疗效,其中行TVT术53例,行TOT术16例,行Lata术19例,行Burch术15例。结果 术后3个月治愈率, 行TVT、TOT、Lata和Burch术的患者,分别为94% (50 /53)、94% (15 /16)、95% (18 /19)和87% (13 /15);手术时间分别为(28±7)、(16±5 )、( 125±13 )和( 43±6 )min;术后留置尿管时间分别为( 26±3 )、(3±1)、(120±6)和(72±5)h。手术并发症有膀胱穿孔,行TVT术患者2例;术后尿潴留,行TVT术患者1例,行Lata患者2例。结论 4种手术对治疗SUI均有相同的疗效;TVT术和TOT术为微创手术,术后患者康复快,住院和留置尿管时间短,可与子宫、阴道脱垂等手术同时进行;行Burch术可与经腹其他手术同时进行。
Objective To evaluate the efficacy and safety of vaginal tension-free urethral sling (TVT), transurethral urethral dural (TOT), autologous fascia lata (Lata) and pubic ligament suspension (Burch) Clinical effect of pressure urinary incontinence (SUI). Methods Retrospective analysis of 103 cases of urinary incontinence and partial combined uterine and vaginal prolapse patients underwent different surgical treatment, including 53 cases of TVT surgery, TOT 16 cases underwent Lata in 19 cases, Burch in 15 cases. Results The cure rates at 3 months postoperatively were 94% (50/53), 94% (15/16), 95% (18/19), and 87% (87/19) in patients undergoing TVT, TOT, The operative time was (28 ± 7), (16 ± 5), (125 ± 13) and (43 ± 6) min respectively. The time of catheterization was (26 ± 3), ± 1), (120 ± 6) and (72 ± 5) h. Surgery complications were bladder perforation, 2 patients underwent TVT surgery; postoperative urinary retention, 1 patient underwent TVT and 2 patients underwent Lata. Conclusions The four kinds of operation have the same curative effect on the treatment of SUI. The TVT and TOT are minimally invasive surgery. The postoperative recovery of patients is quick, the time of hospitalization and indwelling catheter is short, and they can be performed simultaneously with uterine and vaginal prolapse. Burch surgery can be carried out simultaneously with other transabdominal surgery.