经阴道无张力尿道中段悬吊术治疗女性压力性尿失禁临床分析

目的探讨女性压力性尿失禁的微创治疗及减少手术并发症的方法。方法采用经阴道无张力尿道中段悬吊术（Tension-free vaginal tape,TVT）治疗女性压力性尿失禁患者47例,对其中30例合并子宫脱垂和（或）阴道壁脱垂者同时行经阴道子宫切除术和（或）阴道壁修补术。结果 47例患者手术时间33～50min,平均39min;出血量10～50mL,平均20mL。术中无膀胱、尿道或神经损伤等并发症,术后无血肿形成。术后7例出现排尿困难,其中1例尿潴留。平均随访时间23个月,4例失随访。统计43例,治愈率为83.72%（36/43）,有效率为11.63%（5/43）,无效2例,占4.65%。单纯TVT手术与TVT同时行子宫切除术和（或）阴道壁修补术的患者,治愈率和并发症发生率相比较,差异无统计学意义（P〉0.05）。结论 TVT手术可安全有效地治疗女性压力性尿失禁;TVT手术同时行子宫切除术和（或）阴道壁修补术是可行的。

Clinical analysis of tension-free vaginal tape for patients with female stress urinary incontinence

Objective To review the surgical outcomes of tension-free vaginal tape(TVT) for treatment of female stress urinary incontinence(SUI).Methods Used vaginal no tension urethral middle suspension technique(TVT) treatment of female stress urinary incontinence of 47 patients with 30 cases of them merge uterine prolapse and(or) vaginal wall prolapse per son at the same time through vaginal hysterectomy and(or) vaginal wall suture.Results The operation time of 47 patients were 33 to 50 min,the average of 39 min,amount of bleeding was 10 to 50 mL,the average of 20 mL.There was no blad der,urethra or nerve damage,and other complications in intraoperative,postoperative no hematoma formation.7 cases ap pear dysuria in postoperative,among them 1 case of urinary retention.During a mean follow-up of 23 months,4 cases were lost.Statistical in 43 cases,cure rate was 83.72%(36/43),effective rate was 11.63%(5/43),invalid in 2 cases,accounting for 4.65%.Simple TVT operation and at the same time TVT hysterectomies and(or) vaginal wall suture of the patients,the cure rate and complications were compared,and no statistically significant difference(P > 0.05).Conclusion TVT operation is safe and effective treatment of female stress urinary incontinence,TVT operation at the same time hysterectomies and(or) vaginal wall suture is feasible.