摘要
目的比较由外向内经闭孔无张力尿道悬吊术（TOT）及由内向外经闭孔无张力尿道悬吊术（TVT-O）治疗女性压力性尿失禁（SUI）的安全性和有效性。方法回顾性分析我院68例女性SUI患者,30例行TOT术,38例行TVT-O术的临床资料。SUI诊断主要根据患者症状、妇科检查、压力试验及尿动力学检查。术前及术后6个月按照国际尿失禁问卷调查表进行评分,评价其主观治愈率。记录手术时间、术中及术后并发症、术中失血量、术后尿管留置时间、住院天数及术后6~24个月随访结果。结果 TVT-O组术后出现2例大腿内侧疼痛（5.3%）和1例急迫性尿失禁,TOT组出现2例短暂性尿潴留。两组手术时间、术中出血量及住院天数无明显差异（P〉0.05）。两组手术方式均无膀胱穿孔、排尿困难及阴道腐蚀现象。随访6～24个月,TOT组治愈率为97.2%,TVT-O组治愈率为96.3%。两组术后尿失禁生活质量量表（I-QOL）评分明显高于术前,盆腔器官脱垂尿失禁患者性功能问卷（P-ISQ）性生活质量评分术前术后无明显改变。结论 TOT与TVT-O均可作为治疗女性SUI的安全、有效的方法。
Objective To explore the clinical efficacy and safety of outside-in transobturator middle urethral tape（TOT） procedure and inside-out transobturator middle vaginal tape（TVT-O） procedure for the treatment of female stress urinary incontinence（SUI）.Method A total of 68 female patients with SUI were assigned to undergo TOT（n=30） or TVT-O（n=38）.The diagnosis for SUI was confirmed by the patient＇s symptoms,gynecological examinations,pressure tests and urine dynamics examination.The life quality before and after surgical treatment was evaluated by the influence of incontinence to quality of life in stress（I-QOL）.Patients were followed up for 6 months to 24 months.Operative time,intraoperative blood loss,postoperative indwelling catheter time,postoperative hospital stay and intraoperative and postoperative complications were observed.Results Two cases of inner thigh pain（5.3%）,and 1 case of urge incontinence occurred in TVT-O group,and 2 cases of transient urine retention occurred in TOT group postoperatively.The operative duration,intraoperative blood loss,indwelling catheter duration and postoperative hospital stay were not significantly different between the two groups（P〈0.05）.No perforation of the bladder,dysuria and vaginal corrosion was observed in both groups.The curative rate in TOT group and TVT-O group was 97.2% and 96.3% respectively in 6 months follow-up（P〈0.05）.The postoperative I-QOL scores were significantly higher than preoperative ones.There is no significant difference in sexual life quality score of organ prolapse/urinary incontinence sexual funtion questionnaire（P-ISQ） preoperatively and postoperatively in both groups.Conclusions Both TOT and TVT-O were safe and effective for the treatment of female SUI.
出处
《中华腔镜泌尿外科杂志（电子版）》
2013年第4期38-41,共4页
Chinese Journal of Endourology(Electronic Edition)
