改良自体原位阴道前壁吊带治疗女性压力性尿失禁

发表时间：2014-07-08 浏览次数：1092次

引用：

邬绍文，贺飞，张晓忠等.改良自体原位阴道前壁吊带治疗女性压力性尿失禁[J].临床泌尿外科杂志.2013,28(4):282-284

关键词：

尿失禁,压力性；女性；改良；阴道壁吊带；

作者：

邬绍文，贺飞，张晓忠，梅骅，杨青山，宋明哲，陈海

作者单位：

深圳中山泌尿外科医院；

出版年份：

2013

期刊页数：

282-284

收录者：

知网

摘要：

目的:探讨改良自体阴道前壁吊带治疗女性压力性尿失禁(SUI)的可行性及近期疗效。方法:参照TVT-O设计原理,采用自体原位阴道壁吊带治疗女性压力性尿失禁患者10例。取自体阴道壁吊带,将阴道壁吊带两端缝合于盆筋膜腱弓,无需特殊手术器械经闭孔穿刺。结果:10例患者都顺利完成手术,手术平均时间65min,术中平均出血约35ml。无一例出现假性囊肿、感染等并发症。住院时间4～7d,平均5d,术后10例患者尿失禁症状消失,无需配戴尿垫,患者主诉满意。随访9个月～2年,1例术后3个月时复发;1例术后出现排尿困难,给予导尿及药物治疗后症状改善。结论:自行设计改良的自体阴道壁吊带治疗女性压力性尿失禁安全可行,效果同TVT-O手术,但手术费用低。阴道壁吊带是自身组织,避免了TVT-O手术的尿道吊带侵蚀反应的发生。本组病例较少,长期疗效需进一步随诊观察。 Objective: To discuss the feasibility of modified in situ vaginal wall tape for treatment of stress uri- nary incontinence. Method: Ten patients who suffered with stress urinary incontinence were treated with modified in situ vaginal wall tape. The in situ vaginal wall tape replaced for the polypropylene tape being used in TVT-O operation and were sutured with the arcus tendineus of the endopelvic fascia，without the special surgical instru- menu for transobturator puncturing. Result: A total of 10 patients successfully underwent the anti-incontinence op- eration with the in situ vaginal wall tape. The mean operation time was 65 min and the mean blood loss was 35 ml. No severe complications were observed, such as bladder lesion, urethra injury, pseudocyst，infection, injury of obturator vessels and nerves. The mean hospital stay was 5 days (range 4-7 days).The syndrome of stress urina- ry incontinence disappeared after operation. The patients were followed up for 9-24 months. Of the 10 cases，1 was recurrenced at the 3th month of postoperation and 1 had dysuria which was cured after urethral catheterization and drug treatment. Conclusion; Modified in situ vaginal wall tape treatment for female stress urinary incontinence was safe and feasible, the clinical efficacy being same as TVT-O. However, more economical, it greatly reduced the financial burden of patients and the urethral sling erosion reacations observed in TVT-O were avoided with the vaginal wall sling being its own organization. To assess the long term effects need further long term follow up study for fewer cases and lack of long-term follow-up study.

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