天津医药

• 临床论丛 • 上一篇    

尿道中段吊带联合改良盆底重建术治疗女性压力性尿失禁

李会兵1,方平2,王岩3,孙峰3   

  1. 1. 天津医科大学第二附属医院泌尿外科
    2. 天津医科大学第二医院泌尿外科
    3. 天津市泌尿外科研究所
  • 收稿日期:2010-09-30 修回日期:2011-02-21 出版日期:2011-06-15 发布日期:2011-06-15
  • 通讯作者: 方平

Mid-urethral sling combined with Modified pelvic floor Reconstruction in the treatment of female stress urinary incontinence

  • Received:2010-09-30 Revised:2011-02-21 Published:2011-06-15 Online:2011-06-15

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摘要： 摘要 评估经闭孔尿道中段吊带术（TOT）联合改良盆底重建术治疗伴有盆底脱垂的压力性尿失禁（SUI）的临床疗效及安全性。方法：分析我院接受手术的31例患者资料，年龄43~76岁，平均（54.29±10.83）岁，病史1~40年，平均（10.31±8.32）年。通过比较手术前后POP-Q分度和术后Grouts-Blaivas评分判断手术效果，并统计和分析并发症。结果：手术在硬膜外麻醉下完成，手术时间50~120min，平均（70.20±9.88）min，出血量30~100ml，平均（60.87±19.40）ml。术后早期并发症有股部及会阴疼痛4例，排尿困难2例，排尿姿势改变1例，本组无远期并发症。随访6~30个月，平均（18.3±6.21）月，31例患者脱垂症状全部得到纠正，漏尿症状完全消失30例，改善1例，总治愈率96.8%，总体满意率100%，无失败病例。结论：尿道中段吊带术联合改良盆底重建术安全、有效，远期疗效有待大量病例进一步观察。

关键词: 压力性尿失禁, 盆底脱垂, 经闭孔尿道中段无张力吊带术, 改良盆底重建术

Abstract: Abstract Objective：To asses the safety and efficacy of the transobturator tape (TOT) combined with modified pelvic floor reconstruction for surgical treatment of female stress urinary incontinence. Methods：Retrospectively analyzed from January 2008 to December 2009 and 31 women with stress urinary incontinence concomitant pelvic organ prolepses underwent the TOT procedure and modified pelvic reconstruction. 31 women are aged from 43~76 years ;mean age 54.29 years .There disease course raged from 1 to 40 years ;mean 10.31 years. The follow-up time is from 6 to 30 months, mean 18.3 months. Therapeutic effects were assessed by Grouts-Blaivas and POP-Q outcome score .The results of operations, complications of operation were observed. Results：The operations were operated under epidural anesthesia . Mean operation time was 70.2 minutes .Mean blood loss was 60.8 ml. Early complications included femoral puncture site pain in 4 cases, dysuria in 2 cases and 1 cases of urinary posture change. There was no long-term complication. POP-Q and Grouts-Blaivas score to evaluate the efficacy and symptoms disappeared completely 30 cases, long-term cure rate of 96.8%, the overall rate of satisfaction 100%, without failing case. Conclusions：TOT procedure combined with modified pelvic floor reconstruction is a safe and effective approach, the short—time effect is wel1．However, the long time affect need more cases of observation.

Key words: Stress urinary incontinence, pelvic organ prolapse, transobturator tension-free tape, modified pelvic floor reconstruction