中段尿道吊带术治疗女性压力性尿失禁的手术并发症防治

目的探讨中段尿道吊带术的并发症及其防治措施。方法采用中段尿道吊带术治疗女性压力性尿失禁48例,其中,TVT术26例,TVT-O术19例,Sparc术3例。结果手术并发症包括:1例(TVT)术中膀胱镜检发现穿刺针穿入膀胱,经重新调整穿刺纠正。2例(Sparc术和TVT-O术各1例)分别于术后1、3个月发现阴道前壁吊带外露,经再次手术修补阴道前壁治愈。4例出现尿急症状,给予黄酮哌酯对症治疗2周后症状明显改善。2例出现股内侧轻度疼痛,未经特殊治疗,1周内症状自行缓解。结论中段尿道吊带术治疗女性压力性尿失禁方法简便、疗效可靠,但其手术并发症的发生应引起重视。

Prevention and Treatment of Complications due to Mid-urethral Sling Suspension for Female Stress Urinary Incontinence

Objective To investigate the prevention and treatment of complications due to mid-urethral sling suspension.Method 48 patients of female stress urinary incontinence(SUI) were underwent mid-urethral sling suspension,including 26 of tension-free vaginal tape(TVT),19 of trans-obturator vaginal tape inside-out(TVT-O),and 3 of Sparc procedure.Results Four kinds of complications occurred.Bladder puncture was detected by cystoscopy in 1 case,and retrieved by re-puncture during TVT.Tape exposition in anterior vaginal wall was found in 2 cases(TVT-O and Sparc for each) in 1 and 3 month after operation respectively,and cured by repair of the anterior vaginal wall.Urgent urination occurred in 4 patients,and improved by oral administration of flavoxate 2 weeks later.Mild pain of medial thigh was felt in 2 patients,and spontaneously relieved with 1 week.Conclusions Mid-urethral sling suspension is a simple and effective surgical procedure for female SUI;nevertheless,the complications would be got attention.