TVT-O治疗女性压力性尿失禁的临床分析（附38例临床报告）

目的分析经闭孔无张力尿道中段悬吊术（TVT—O）治疗女性压力性尿失禁（SUI）的临床疗效。方法回顾性分析38例用TVT—O治疗的女性SUI的临床资料。结果38例患者术后随访15±3．9月（2～20月），均临床治愈，无SUI复发，完全改善率92．1％（35／38），症状显著好转率7．9％（3／35）。术中无膀胱、闭孔血管神经等损伤；术后3例暂时性排尿困难，尿道扩张并膀胱锻炼后缓解；23例患者术后6月尿流动力学检测显示．平均尿流率（Qave）及最大尿道闭合压（MUCP）明显回复，而其他指标无明显变化；2例患者于术后3周尿失禁复发，术后8周行尿流动力学检查，并以此分别对2例患者进行吊带调整及Burch阴道壁悬吊术，术后未复发。结论TVT—O操作简单、微创、并发症少，是治疗女性压力性尿失禁安全有效的方法。

Clinical analysis of transobturator tension-free vaginal tape-obturator procedure on stress urinary incontinence in 38 female patients

Objective To evaluate the treatment efficacy of tension-free vaginal tape obturator technique （TVT-O） in females with stress urinary incontinence （SUI）. Methods 38 cases of female stress urinary incontinence treated with TVT-O procedure were analyzed retrospectively. Results All cases were followed up for 15~3.9 months（2 - 20 months） in good clinical result without recurrent SUI. The complete dryness rate was 92.1% （35/38）, 7.9% of patients （3/38） showed significant improvement. No hematoma or Madder injury was recorded during the procedures. Urodynamic test of 23 cases showed Qave and MUCP recovered significantly, while no alteration in other items. Postoperative urinary retention was found in 3 patients, and cured with urethral dilatation bladder exercise. Two patient experienced immediate postoperative recurrence 3 weeks later. 8 weeks later operation, urodynamic test was performed; they respectively got tape modulation and Burch operation according to the Results of urodynamic test, and got well after the operation. Conclusion The TVT-O procedure is a safe and efficient surgical treatment for female SUI, which are easy and minimally invasive procedure with less complication.