改良的经闭孔无张力阴道吊带术治疗女性压力性尿失禁18例

女性压力性尿失禁(stress urinary incontinence,SUI)在中老年妇女中很常见,发生率为5%~25%[1],表现为腹压突然增加引起尿液不自主流出。重度SUI患者站立时就可发生尿漏现象,严重影响患者的心理健康和社会生活。手术治疗是中重度SUI的最佳选择,经耻骨后路径的无张力阴道吊带术(     

经闭孔无张力阴道吊带术治疗女性压力性尿失禁

目的 探讨经闭孔无张力阴道吊带术(TVT-O)治疗女性压力性尿失禁(SUI)的临床疗效.方法 回顾性分析19例临床和尿动力学检查诊断为SUI的患者.年龄36～82(58.3±12.2)岁.病程2～30(8.6士5.5)年.结果 手术时间12～25(15±3)min,术中出血量均＜30 ml.未出现膀胱穿孔、阴道穿孔、伤口感染和吊带排异等并发症.术后2 d拔除导尿管,16例即获得满意控尿;3例拔管后仍有轻微尿失禁,1周后症状自行缓解,2例出现大腿根部酸痛,3 d后症状均自行缓解,未做特殊处理.全组未出现排尿困难和尿潴留现象,术后平均住院时间2.5 d.所有病例均获随访3～19个月,无尿失禁复发.结论 TVT-O术简捷、微创,并发症少,疗效确切,是一种治疗女性SUI安全有效的方法.     

无张力阴道吊带术治疗女性压力性尿失禁

目的 探讨无张力阴道吊带术（TVT）治疗女性压力性尿失禁的疗效。方法 42例女性压力性尿失禁患者,行无张力阴道吊带术,观察术后效果,研究该术式治疗女性压力性尿失禁的临床效果。结果 42例均行该术式,手术时间25-55min,失血量20-100ml,术后住院时间1～4d。随访3～26个月,34例治愈,8例有效。结论 无张力阴道吊带术是一种微创、有效、简单易行的术式。     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

目的探讨经闭孔无张力尿道中段悬吊术TVT-O治疗女性压力性尿失禁SUI的疗效及安全性。方法回顾性分析2006年4月至2008年6月接受TVT-O的28例女性SUI患者的临床资料,随访时间4—24个月。结果手术时间平均23min（10～30min）,术中出血量平均24ml（15—40ml）。3例术后排尿困难,保留尿管3d后自行排尿。术后能达到完全控尿24例（85．7％）,有效控尿4例（14．3％）。结论TVT-O是目前治疗女性SUI的一种有效、安全的微创手术。     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

无张力阴道吊带术治疗女性压力性尿失禁20例

目的探讨微创技术治疗女性压力性尿失禁的可行性和临床疗效。方法女性压力性尿失禁患者20例,经临床、尿动力学检查或膀胱尿道造影确诊,均为稳定性膀胱,无膀胱出口梗阻。采用无张力阴道吊带术（TVT）,将吊带无张力置于尿道中段。结果手术时间平均（50±5）min;术中出血量平均（47±10）ml;术后平均留置导尿2d;术后平均住院4d。18例患者术后尿失禁症状均消失,其中1例患者术后出现尿潴留,留置导尿1周后好转,尿潴留症状消失,尿失禁未复发;1例尿失禁症状显著改善。结论应用TVT治疗女性压力性尿失禁具有简单、微创、疗效好、并发症少等优点,值得临床推广。     

无张力阴道吊带术治疗女性压力性尿失禁材料的研究

目的应用聚四氟乙烯（Teflon）补片代替聚丙烯网带进行无张力阴道吊带术（TVT）治疗女性压力性尿失禁（SUI）,以寻求一种性能稳定、组织容性良好、经济实用的吊带材料。方法选择女性SUI患者30例,将Teflon补片裁剪成1.45 cm带状并植入尿道的中段或远段的下方,两端分别从耻骨上缘正中线两旁引出,观察术后疗效及并发症。结果术后患者均无伤口感染,无吊带排斥,无尿失禁复发,无尿瘘及尿路感染等并发症。结论 Teflon补片具有组织相容性好,用它替代聚丙烯网带进行TVT治疗女性SUI疗效明显,且价格相对低廉,值得临床推广应用。     

无张力阴道吊带术治疗压力性尿失禁

目的观察无张力阴道吊带手术治疗压力性尿失禁的临床疗效。方法2002年1月～2004年7月,采用无张力阴道吊带术治疗压力性尿失禁17例。结果17例患者均手术成功,术后全部病例随访6～30个月,平均23个月,15例治愈,治愈率88．2％,2例再次出现尿失禁。结论无张力阴道吊带手术效果是肯定的,值得应用推广。     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁

随着人类寿命的延长和对生活质量要求的提高,压力性尿失禁（stress urinary incontinence,SUI）日益受到妇产科医生的重视。现将我院妇产科在2008年3月到2009年8月应用经闭孔无张力尿道中段悬吊术（TVT-O）治疗SUI42例临床资料加以分析,报告如下。     

三种手术方式治疗女性压力性尿失禁疗效评价

目的：评价改良Kelly术式、无张力阴道吊带术（TVT）和经闭孔无张力阴道吊带术（TVT-O）3种手术方式治疗女性压力性尿失禁的疗效。方法选取2001年2月～2012年2月收治的女性压力性尿失禁患者102例，分别采用改良Kelly术式、TVT和TVT-O 3种术式，分三个时段由同一组医生完成手术，观察3种术式的手术成功率。结果改良Kelly术式手术时间42～62 min，手术成功率：1年95%，4年65%；TVT术式手术时间48～70 min，手术成功率：1年93%，4年83%；TVT-O术式手术时间25～42 min，手术成功率：1年94%，4年92%。结论TVT-O术式方法更为简单，操作安全，并发症少，近、远期疗效稳定，能有效治疗女性压力性尿失禁。     

女性压力性尿失禁经闭孔肌无张力吊带手术前后的护理

<正>女性压力性尿失禁(stress urinary incontinence,SUI)是中老年女性的一种常见病症,当咳嗽、喷嚏、大笑、起立等腹压突然提高时,尿液失去控制不由自主地流出,给患者带来一系列生理、精神、生活方面的困扰,严重影响妇女的生活质量和身心健康。笔者所在科对SUI患者行经闭孔肌无张力吊带术(TOS)。现将护理体会报告如下。     

经闭孔无张力尿道中段悬吊术治疗女性尿失禁11例分析

压力性尿失禁（SUI）是严重影响中老年女性生活质量的一种疾病。随着全球的老年化,SUI的发病率日益增高。经闭孔无张力尿道中段悬吊术（TVT-O）是治疗压力性尿失禁的一种外科方式。2006年8月至2010年3月,我院采用TVT-O治疗SUI患者11例。现报告如下。