尿道中段无张力悬吊带术治疗女性压力性尿失禁

目的：探讨女性压力性尿失禁（stress urinary incontience，SUI）的手术治疗效果。方法：采用尿道中段无张力悬吊带术治疗41例女性压力性尿失禁患者，其中经阴道无张力悬吊带术（tension-free vaginaltape，TVT）治疗33例，经耻骨上途径无张力悬吊带术（suprapubic Arch sling，SPARC）治疗8例。结果：41例手术时间25～50min（平均35．5min），出血量10～25ml（平均15m1）。膀胱损伤5例．2例为双侧损伤。40例患者拔尿管后排尿良好，1例因带气囊拔尿管而损伤尿道．出现尿潴留。术后随访1～23个月，4例患者在明显增加腹压时有少许尿液滴出，其余患者皆可很好地自主控尿，1h尿垫试验〈2g，治愈率为90．2％（37／41）。结论：尿道中段无张力悬吊带术可有效地治疗女性压力性尿失禁。

Tension- free mid-urethral tape for female stress urinary incontinence

Objective:To explore the surgical results for female stress urinary incontinence(SUI) by tension- free mid-urethral tape. Methods: Fourty-one females with stress urinary incontinence were treated with tension- free mid-urethral tape . Of them, 33 patients were treated with tension - free vaginal tape (TVT), 8 with suprapublic arch sling (SPARC). Results : All the operation were finished within 25~50 minutes (mean 35.5 minutes) and with the estimated blood lost within 10~25 ml(mean 15.5ml). 5 cases had bladder perforations , of which 2 had bilateral injuries. 1 case had uretheral injury and retention of urine. Followed up from1 to23 months, 37 patients were cured successfully (1-hour pad test result was less than 2g), 4 patients had little urine incontinence when the abdominal pressure was increased , the cure rate was 90.2%(37/41),. Conclusion:Tension- free mid-urethral tape is a safe, effective and minimally invasive surgical procedure for treatment of the female stress urinary incontincene .