经闭孔与经耻骨后尿道中段无张力悬吊术治疗压力性尿失禁的疗效观察

目的对经闭孔和经耻骨后尿道中段无张力悬吊术治疗压力性尿失禁的两种手术方式进行对比评估。方法对采用经耻骨后尿道中段无张力悬吊术治疗的47例患者和经闭孔尿道中段无张力悬吊术的30例患者就手术安全性、疗效及并发症等方面进行回顾性分析。结果两组在术中出血、损伤、近期尿潴留、治愈率及满意度方面无显著性差异，经闭孔尿道中段无张力悬吊术的手术时间明显少于经耻骨后尿道中段无张力悬吊术（P〈0，05）。结论经闭孔通路和传统的耻骨后通路对尿失禁的治疗效果是相似的。但经闭孔尿道中段无张力悬吊术的术中大出血、膀胱和肠管损伤等并发症能够基本排除，并因术中省略了膀胱镜检查，简化了手术步骤而使手术时间缩短，该术式有望为更多的医师所接受。

Study on the Effectiveness of Transobturator Tension-Free Tape and Retropubic-Mid-urethral Sling in the Treatment of Stress Urinary Incontinence

Objective To evaluate the differences between transobturator tension-free Tape and retropubic mid-urethral sling for the surgical treatment of stress urinary incontinence. Methods A retrospective study of patients who had under went these two managements. Operating condition, recovery, post-operation effects and complications are compared respectively. Results The differences between these two groups on operating time, bleeding loose , operation injury, immediate postoperative urinary retention, cure rates, and patient satisfaction had no statistic significance. Conclusion The effects between Transobturator and Retropubic mid-urethral sling are similar. TVT-O procedure destroys physical structure less, avoids gloss bleeding, and puncturing the bladder or bowels . TVT-O is effective and easier to perform. It may become the best procedure to manage urinary incontinence. However, long-term effects require further observation.