经闭孔经阴道前壁尿道悬吊术治疗压力性尿失禁的短期临床效果

目的通过对经闭孔经阴道前壁尿道悬吊术（TVT-O）治疗的女性压力性尿失禁患者进行术前、术后生活质量及盆底功能评分,探讨TVT-O手术的短期临床效果。方法选取2010年1月至2012年4月在郑州大学第三附属医院行TVT-O手术治疗的中、重度压力性尿失禁患者103例,其中单纯性压力性尿失禁患者73例,进行完整随访的72例,对其术前、术后1、3、6个月和12个月分别行盆底功能障碍问卷（PFDI-20）、尿失禁影响问卷简版（IIQ-7）、盆底障碍影响简易问卷（PFIQ-7）及盆底脏器脱垂/尿失禁性功能问卷（PISQ-12）的评分。对评分结果进行总结。结果术后不同时间PFDI-20、IIQ-7、PFIQ-7、PISQ-12的评分与术前比较差异均有统计学意义（P均﹤0.01）。其中PFDI-20、IIQ-7、PFIQ-7生活质量评分在术前、术后1、3个月呈递降（P〈0.01或P〈0.05）,术后6、12个月则稳定在与3个月相近的水平（P均〉0.05）;PISQ-12的评分术后6个月与术前比较无变化（P〉0.05）,术后12个月明显升高（P〈0.01）。结论 TVT-O治疗可提高女性压力性尿失禁患者的生活质量,疗效在术后3～6个月达到稳定,对性生活质量的影响是可逆的。

Short-time efficacy of tension free vaginal tape-obturator for treatment of stress urinary incontinence

Objective To explore the short-time efficacy of tension free vaginal tape-obturator （TVT-O） for the treatment of female stress urinary incontinence （SUI） patients through the grading for preoperative and postoperative life quality and pelvic floor functions. Methods Out of 103 eases of moderate and severe SUI who were treated by TVT-O between January 2010 and April 2012,72 single SUI patients obtained complete follow-up were enrolled in this study. The scores of Pelvic Floor Dysfunction Inventory （ PFDI-20 ）, Urinary Incontinence Impact Questionnaire Short Form （IIQ-7）, Pelvic Floor Disabilities Impact Simple Questionnaire （PFIQ-7） and Pelvic Organ Prolapse/Urinary Incontinence and Sexual Function Questionnaire （PISQ-12） were respectively made before operation and 1,3,6,12 months after operation, and the results were summarized. Results Compared with pre-operation,the scores of PFDI-20, HQ-7, PFIQ-7 and PISQ-12 were all improved in post-operational different times （ all P 〈 0.01 ）. The life quality grading of PFDI-20, IIQ-7, PFIQ-7 in pre-operative and 1-, 3-month after operation reduced gradually in turn （ P 〈 0.01 or P 〈 0.05 ）, and in 6,12 months after operation stabilized at similar levels with 3 months after operation （all P 〉 O. 05 ）. Compared with pre-operation ,the PISQ-12 score 6 months after operation remained unchanged （ P 〉 0.05 ） , but increased significantly 12 months after operation （ P 〈 0. O1 ）. Conclusions TVT-O technique can improve the life quality of female SUI patients. The efficacy reaches a stabilization level 3 to 6 months after operation. The influence on the quality of sexual life is reversible.