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11.
Pierre Collinet Calin Ciofu Pierre Costa Michel Cosson Bruno Deval Philippe Grise Bernard Jacquetin Francois Haab 《International urogynecology journal》2008,19(5):711-715
This study examines the safety of the inside-out transobturator approach for transvaginal tape (TVT-O™, Gynaecare) treatment
in stress urinary incontinence (SUI) in women based on a French registry of patients. A total of 984 women from 86 centres
were enrolled in the study. Patients with predominant overactive bladder or significant pelvic organ prolapse were excluded
from the study. Perioperative and post-operative complications were reported as well as urinary function at 4 and 12 weeks.
Pain was assessed by the patients using a visual analog scale (VAS). The overall perioperative complication rate was 2.2%.
The most commonly reported morbidities were vaginal wall perforation (1.3%) followed by haematoma (0.7%). Post-operative complication
rate was 5.2%; the most common complication was residual pain (2.7%). The other complications of paravesical haematoma, urinary
retention, vaginal erosion and re-intervention had an incidence of less than 1.0%. This study demonstrates that the transobturator
transvaginal tape approach to the treatment of SUI is a safe procedure. 相似文献
12.
Ming-Ping Wu Kuan-Hui Huang Cheng-Yu Long Kuo-Feng Huang Ken-Jen Yu Chao-Hsiun Tang 《International urogynecology journal》2008,19(12):1639-1646
This study aims to identify the changing trends of different surgical types for female stress urinary incontinence (SUI) and
the distribution amongst various providers’ characteristics. A total of 17,532 women who had undergone surgery for SUI during
1996–2005 were identified from the National Health Insurance Research Database for analysis. Retropubic urethropexy (RPU)
was the most common surgical type (43%), followed by tension-free mid-urethral sling (MUS; 24%), and traditional pubovaginal
sling (15%). MUS had an annual growth rate of 20.5%, whilst traditional pubovaginal sling was reduced by 11.3% annually after
2002. RPU was the most common procedure by both gynecologists and urologists. Gynecologists performed more Kelly plications,
whereas urologists performed more traditional pubovaginal sling. MUS was more commonly performed in medical centers than in
regional and local hospitals. There has been a notable growth and changing trend in various surgical types for female SUI
in Taiwan. 相似文献
13.
Anne P. Cameron Christina Lewicky-Gaupp Abigail R. Smith Brian T. Helfand John L. Gore J. Quentin Clemens Claire C. Yang Nazema Y. Siddiqui H. Henry Lai James W. Griffith Victor P. Andreev Gang Liu Kevin Weinfurt Cindy L. Amundsen Catherine S. Bradley John W. Kusek Ziya Kirkali 《The Journal of urology》2018,199(4):1023-1031
14.
杨志永 《华北煤炭医学院学报》2010,12(4):520-520
女性压力性尿失禁(SUI)是指在没有逼尿肌收缩的情况下,由于腹内压的增加(如咳嗽、喷嚏、运动时)导致尿液不自主溢出,是女性常见病和多发病。35%~45%的女性有不同程度的尿失禁症状,且随着年龄的增长而加重。65岁以上女性患病率高达51.1%,严重影响患者生活质量和身心健康。近年来多采用无张力尿道中段悬吊术(TVT)、 相似文献
15.
压力性尿失禁动物模型两种建立方法比较 总被引:1,自引:0,他引:1
目的:模仿产伤和破坏大鼠尿道周围组织两种方法建立压力性尿失禁动物模型,并对两种动物模型进行鉴定和比较?方法:雌性成年未生产过的Sprague-Dawley 大鼠45只,取5只直接开腹测量尿动力学作为对照组,其余分为A组 20 只,B组 20 只?A组行阴道损伤和双侧卵巢切除术,B组行尿道分离术和双侧卵巢切除术?A和B组大鼠各分为4小组,分别称A1-A4和B1-B4,每小组为 5只,分别在术后1周,1?2?3月后测量尿动力学指标LPP 和ALPP?每组各取2只大鼠行组织学鉴定?结果:与对照值相比A1~A4组LPP值有统计学意义(A1~A3 P < 0.01,A4 P < 0.05),ALPP值有统计学意义(A1~A3 P < 0.01,A4 P < 0.05),A1~A4组间比较P > 0.05,无明显统计学差异?与对照值相比B1~B4组LPP值有统计学意义(B1~B4 P < 0.05),ALPP值有统计学意义(B1~B4 P < 0.01),B1~B4组间比较P > 0.05,无明显统计学差异?A组和B组组间比较无明显差异(P > 0.05)?动物模型尿道组织学上表现为即肌肉成分的萎缩,断裂及神经分布的减少?结论:两种方法均能成功建立SUI动物模型,两种建立方法无明显差异?两种方法建立的模型在3个月内可维持比较良好的稳定性?模拟产伤法具有操作相对简单?风险小?学习曲线短等特点,值得推广? 相似文献
16.
女性压力性尿失禁是一种常见疾病,其发生率随妇女年龄的增长而增加,影响着妇女的生活质量和身心健康.压力性尿失禁定义为腹压的突然增加导致尿液不自主漏出.压力性尿失禁是由于腹内压升高并下传到膀胱使膀胱内压的升高超过膀胱颈和尿道括约肌产生的压力而导致漏尿.压力性尿失禁以手术治疗为主,手术治疗方案很多.该文主要综述目前可行的几种手术方式和临床观察的数据,新的手术方式及对材料的近期观察结果显示出了良好的治愈率和较高的患者满意率及较低的并发症发病率,但目前尚缺乏关于新术式和新材料长期有效的观察数据. 相似文献
17.
目的了解围绝经期和绝经后妇女盆腔脏器脱垂(pelvic organ prolapse,POP)患者临床相关的压力性尿失禁的尿动力学特点,分析盆腔脏器脱垂和压力性尿失禁(stress urinary incontinence,SUI)的关系。方法研究对象为2003年1月至2006年12月因盆腔脏器脱垂或压力性尿失禁在本院住院手术的108例经产妇。对98例进行临床尿动力学检查,包括腹压漏尿点压(ALPP)、静止性尿道压力(UPP)测定[功能性尿道长度(FUL)、最大尿道压(MUP)、最大尿道关闭压(MUCP)]。盆腔脏器脱垂诊断分期,按国际尿控制协会盆腔器官脱垂分期(POP—Q)进行(分组征得患者知情同意)。结果盆腔脏器脱垂患者中,临床诊断的压力性尿失禁占68.5%(74/108)。完成尿动力学检查的盆腔脏器脱垂患者的腹压漏尿点压测出率高达71.4%(70/98)。SUI组(n=70)患者的腹压漏尿点压测出率为87.1%(61/70)。其中,腹压漏尿点压〈90cm H2O为56.1%(55/98),≤60cm H2O为26.5%(26/98)。非SUI组患者中,腹压漏尿点压呈阳性的患者为32.1%(9/28)。腹压漏尿点压均数比较,SUI组明显低于非SUI组(P〈0.001)。以腹压漏尿点压测定为标准,盆腔脏器脱垂患者的隐性压力性尿失禁可能性为9.2%(9/98)。SUI组与非SUI组患者的尿动力学检测结果比较,功能性尿道长度、最大尿道压、最大尿道关闭压值,差异无显著意义(P〉0.05)。结论无压力性尿失禁的盆腔脏器脱垂患者与压力性尿失禁患者功能性尿道长度、最大尿道关闭压比较,差异无显著意义。建议在盆腔脏器脱垂矫治术中,对无压力性尿失禁症状,且功能性尿道长度变短、最大尿道关闭压、最大尿道压低者,行预防性压力性尿失禁矫治术。 相似文献
18.
电刺激联合生物反馈治疗中老年女性压力性尿失禁57例临床观察 总被引:1,自引:0,他引:1
目的:探讨电刺激联合生物反馈治疗中老年女性压力性尿失禁的效果。方法采用法国PHENIX神经肌肉刺激治疗仪对57例中老年妇女压力性尿失禁患者治疗1-2个疗程,治疗3个月后进行随访、复诊,评价疗效。结果57例患者治愈21例(36.8%),有效24例(42.1%),无效12例(21.1%),总有效率为78.9%。子宫脱垂和阴道膨出的患者均感到脱出物有不同程度的回缩。34例性生活不满意患者均有不同程度改善。盆底肌Ⅰ类肌纤维疲劳度改善不明显(P>0.05),Ⅱ类肌纤维疲劳度、Ⅰ类及Ⅱ类肌肌力、每周平均漏尿次数、A3反射异常、综合肌电位值均明显改善( P<0.05)。结论电刺激联合生物反馈是治疗中老年女性压力性尿失禁的一种有效、简便、无创伤的方法,值得推广。 相似文献
19.
《Archives of physical medicine and rehabilitation》2014,95(12):2231-2238
ObjectiveTo evaluate the effects of sacral magnetic stimulation (SMS) on functional and urodynamic improvement in patients with refractory stress urinary incontinence (SUI).DesignA sham-controlled, double-blind, parallel study design with a 4.5-month follow-up.SettingA tertiary hospital.ParticipantsWomen (age, 45–75y) with SUI refractory to first-line management (N=34) were allocated to either an experimental (n=20) group or a sham (n=14) group.InterventionsThe SMS protocol consisted of 5-Hz, 20-minute treatments administered over the bilateral third sacral roots, with the intensity set at approximately 70% of the maximal output, for 12 consecutive weekdays.Main Outcome MeasuresUrodynamic assessments and 2 life stress questionnaires, namely, the Urge-Urinary Distress Inventory (U-UDI) and the Overactive Bladder Questionnaire (OAB-q), were administered pre- and post-SMS intervention. We administered the U-UDI (primary outcome measure) and the OAB-q at 3-week intervals during the follow-up period until 18 weeks after the final intervention.ResultsThe experimental group exhibited significant improvements in both U-UDI and OAB-q scores postintervention (P=.011–.014) and at follow-up visits (P<.001–.007) compared with the sham group. In addition, significant increases in bladder capacity, urethral functional length, and the pressure transmission ratio (P=.009–.033) were noted postintervention. Multivariate regression analysis revealed that patients with more severe symptoms benefited more from SMS. A poorer baseline U-UDI score and a shorter urethral functional length were associated with a greater response to SMS.ConclusionsOur observations of a greater response to SMS in patients with more severe SUI than in those with mild symptoms, as well as the long-term benefits of the treatment, confirm the efficacy of SMS in treating SUI. 相似文献
20.
目的了解上海市社区中老年女性压力性尿失禁患者关于疾病知识、尿失禁日常生活管理技巧和盆底肌锻炼的认知水平,并探讨其影响因素。方法采用目的抽样和便利抽样相结合的方法,在上海市3个社区抽取40岁及以上女性1 500例进行尿失禁筛查,采用国际尿失禁咨询委员会编制的尿失禁问卷、压力性尿失禁知识问卷对筛查得到的307例患者进行调查。结果社区中老年女性压力性尿失禁患者疾病相关知识的总分为(4.14±3.51)分,其中疾病知识、日常生活管理技巧和盆底肌锻炼知识的答对率分别为15.2%、33.4%和10.2%。多元线性逐步回归显示,文化程度是影响社区中老年女性压力性尿失禁患者疾病相关知识认知水平的重要因素。结论目前社区中老年女性对于压力性尿失禁的认知水平普遍较低,盆底肌锻炼知识尤为缺乏,亟需普及相关的健康知识和进行有效的社区干预。 相似文献