两种入路尿道中段悬吊术治疗女性压力性尿失禁的临床效果比较

目的 比较经耻骨后和闭孔入路经阴道尿道中段无张力悬吊术治疗女性压力性尿失禁的临床效果和并发症.方法 应用经阴道尿道中段无张力悬吊术治疗女性压力性尿失禁患者134例,根据手术入路的不同分为两组:耻骨后组(32例)和闭孔组(102例).对两组的手术时间、失血量、治愈率和有效率以及术后并发症进行比较.结果 耻骨后组和闭孔组的手术时间分别为(24±6)min和(22±5)min,术中失血量分别为(45±27)ml和(54±23)ml,治愈率分别为81.25%和78.43%,有效率分别为96.88%和98.04%,两组比较差异无统计学意义(P＞0.05).两组术后并发症的发生率分别为:新发尿急6.25%和5.88%,排尿困难:3.13%和2.94%,膀胱损伤:3.13%和0%,阴道损伤:0%和2.94%,两组比较差异无统计学意义(P＞0.05).术后腹股沟疼痛的发生率分别为3.13%和20.59%,两者差异有统计学意义(P＜0.05).结论 耻骨后入路和闭孔入路尿道中段悬吊术均是治疗女性SUI的有效术式.

Comparison of retropubic and transobturator tape placement for the treatment of female urinary incontinence

Objective To compare the efficacy and complications of rctropubic and transobturator tape placement for the treatment of female stress urinary incontinence(SUI).Methods 134 cases of SUI treated with midurethral tape procedures were divided into two groups according to the way of tape placement:retropubic group(32 cases)and transobturator group(102 Cases).The operating duration,blood loss and complications of two procedures were analyzed statistically.Results The average operating duration of retropubic group and transobturator group was(24±6)and(22±5)min,and average blood loss (45±27)and(54±23)ml,respectively.The curative rate was 96.88% and 98.04% in retropubic and transobturator groups respectively.There was no significant difference(P＞0.05).The complication rate of the two groups was similar(P＞0.05),including de novo uregency,voiding dysfunction,bladder and vaginal injures.But groin pain was more common in transobturataor group than in retropubic group(P＜0.05).Conclusion Although there are two different ways of tape placement,midurethral tape procedures are efficacious for the treatment of female SUI.