TVT-Abbrevo术治疗女性压力性尿失禁的疗效观察

目的:探讨TVT-Abbrevo术治疗女性压力性尿失禁的疗效及并发症。方法:2012年11月~2014年2月采用TVT-Abbrevo术治疗女性压力性尿失禁患者共52例,以术后患者主观症状的改善与否作为疗效的判断标准,观察患者的临床疗效及手术相关并发症。结果:手术时间为15~25min,平均(18.7±8.2)min;术中出血量为5~25ml,平均(13.6±4.9)ml。1例术中出现血尿,经膀胱镜检查发现膀胱颈损伤,经阴道予以修补。无尿道、神经损伤,无尿潴留发生。随访3~16个月,平均12.8个月,治愈46例(88.4%),改善3例(5.8%),无效2例(3.8%),有效率达96.2%。最大尿流率(Qmax)为(18.16±6.21)ml/s。腹股沟处疼痛(Vas疼痛评分):手术当天0分9例,0~3分43例;术后第1天0分12例,0~3分40例;术后第2天0分21例,0~3分31例;术后第3天0分41例,0~3分11例;术后2周0分49例,0~3分3例;术后1个月0分52例。术后无耻骨后血肿、吊带侵蚀、排尿困难及感染等相关手术并发症。结论:TVT-Abbrevo术治疗女性压力性尿失禁是安全、有效的,且术后腹股沟疼痛发生率和疼痛程度轻。

TVT-Abbrevo in treatment of female stress urinary incontinence

Objective：To explore the effectiveness and complications of TVT-Abbrevo（tension-free vaginal tape-obturator）in treatment of female stress urinary incontinence（SUI）.Method：From Nov.2012 to Feb.2014,52 patients suffering from SUI were treated with TVT-Abbrevo procedure.The postoperative subjective symptoms were regarded as the judgement of efficacy criteria.The clinical efficacy and operation-correlated complications were observed.Result：Intraoperative blood loss was 5-25 ml〔mean（13.6±4.9）ml〕,and operating time was 15-25min〔mean（18.7±8.2）min〕.One case of intraoperative hematuria was found bladder neck injury by cystoscopy,and repair was done through transvaginal approach.No injury of urethra or nerve were recorded,and no retention of urine was found.Average follow-up period was 12.8（range,3-16）months.The results were as follows：46（88.4%）cases were cured;three（5.8%）cases improved;two（3.8%）cases were ineffective;and96.2% were efficient.Qmax was（18.16±6.21）ml/s.The postoperative groin pain（Vas pain grade）data were as follows：nine cases were found grade zero and 43 cases were found grade 0-3on day of surgery;on the first postoperative day 12 cases were found grade zero and 40 cases were found grade 0-3;on the second postoperative day21 cases were found grade zero and 31 cases were found grade 0-3;on the third postoperative day 41 cases were found grade zero and 11 cases were found grade 0-3;49cases were found grade zero and three cases were found 0-3two weeks after the surgery;at last,all patients were found grade zero four months postoperatively.No postoperative retropubic hematoma,tape adjustment,dysuria,urinary tract infections and other complications occurred.Conclusion：TVT-Abbrevo procedure is safe and effective in treatment of SUI,and associated with low incidence and degree of postoperative groin pain.