经闭孔无张力尿道中段吊带术联合阴道前壁修补术治疗女性压力性尿失禁

目的 评价经闭孔无张力尿道中段吊带术(TVT-O)联合阴道前壁修补术治疗合并阴道前壁脱垂的女性压力性尿失禁(stress urinary incontinence,SUI)的效果.方法 行TVT-O联合阴道前壁修补术治疗合并阴道前壁脱垂的女性压力性尿失禁18例.术后随访12个月,进行主观治疗结果及术后远期并发症的调查.术后12个月时,复查盆腔器官脱垂定量分度法(POP-Q)分期、尿流率、性生活质量评分(PISQ-12).结果 尿失禁主观治愈率为88.9%(16/18),主观改善率为11.1%(2/18).4例阴道前壁脱垂复发(术前Ⅲ期3例,Ⅱ期1例,术后均为Ⅰ期),11名有规律性生活的患者PISQ-12评分术前术后分别为27.5±4.4和31.2±6.1(P＜0.05).结论 TVT-O联合阴道前壁修补术治疗合并中度阴道前壁脱垂的女性压力性尿失禁简便易行,疗效可靠,对患者性功能无不利影响.

Combine Transobturator Tension Free Vaginal Tape and Anterior Colporrhaphy for Female Stress Urinary Incontinence

Objectives To describe the clinical outcome of combining transobturator tension-free vaginal tape (TVT-O) and anterior colporrhaphy for surgical treatment of female stress urinary incontinence(SUI) with proapse vaginae anterior. Methods 18 cases of women who had undergone TVT-O and anterior colporrhaphy were followed up for 12 months. The subjective cure rate and postoperative complications were analyzed. 12 months postoperative, POP-Q degree and urine flow rates, pelvic organ prolapse/urinary incontinence sexual function questionnaire(PISQ-12) were evaluated and compared with which preoperative. Results The subjective cure/improved rates of SUI were 88.9% and 11.1%, respectively. 3 patients had recurrent prolapse vaginae anterior. The average score of PISA-12 of 11 patients was 27.5 ± 4.4 and 31.2 ± 6. 1 before and after surgery (p ＞ 0.05). Conclusions Combining TVT-O and anterior colporrhaphy is an effective 、easy and safe procedure for surgical treatment of female SUI with mid-degree prolapse vaginae anterior with high success rates and has no adverse effect on their sexual life.