目的观察改良的经闭孔无张力吊带尿道中段悬吊术(modified tension-flee vaginal tape-obturator,改良TVT—O术)治疗女性中重度单纯性压力性尿失禁(stress urinary incontinence, SUI)的长期疗效。方法收集同济大学附属同济医院妇产科2005年3月~2006年12月收治的58例女性中重度单纯性SUI患者行改良TVT—O手术的临床资料,回顾分析并进行术后1、3、6、12个月及每年定期随访,观察手术治疗的短期及长期治疗效果及并发症。结果58例女性中重度单纯性SUI进行改良TVT—O手术的患者中,1年随访时均治愈或好转、未出现无效或复发,2年随访时失访3例(5.17%)、复发3例,复发者均行再次手术,术后症状均逐步好转,3年随访时1例高龄患者死亡,其余病例3年及以后每年随访均未复发,治愈46例(79.31%),好转8例(13.79%),其中4例出现了急迫性尿失禁的表现,经药物治疗又有所好转。结论改良TVT-O术治疗女性中重度单纯性SUI,手术操作简便、用时短、出血少,经短期及长期随访治愈好转率高,疗效均可靠。
Objective To evaluate the long-term efficacy of modified tension-free vaginal tape- obturator (modified TVT-O) in treatment of moderate and severe female stress urinary incontinence (SUI). Methods Fifty-eight patients with simple moderate and severe SUI were treated with modified TVT-O in Tongji Hospital from March 2005 to December 2006. Patients were followed-up at 1, 3, 6, 12 month postoperatively and annually after then, the surgical efficacy and complications were analyzed. Results During the first year of follow-up all patients were cured or improved and there were no recurrence or invalid treatment. In the second year 3 cases (5.17%) were lost in follow-up, and SUI was recurrent in 3 out of 55 patients, who received re-operation and symptoms were improved. In the third year of follow-up no more recurrence was observed except one case oleo. The overall cure and improve rate was 79. 31% (46/58) and 13. 79% (8/58), respectively. Conclusion Both the short and long-term efficacy of the modified TVT-O is satisfactory in treatment of female moderate and severe SUI.