回顾性分析女性压力性尿失禁的临床特点及经闭锁无张力阴道带的疗效

Q4 Medicine

中华泌尿外科杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.CN112330-20190807-00358

Ruixiang Song, Xing-Chun He, Guodong Wang, Huizhen Li

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引用次数: 0

摘要

目的探讨女性压力性尿失禁(SUI)患者的临床特点及经闭式阴道无张力胶带手术的疗效。方法回顾性分析2009年10月至2018年6月在海军医科大学附属上海长海医院行经闭口无张力阴道带术的319例患者的临床资料。患者年龄39 ~ 91岁，平均(59.2±9.7)岁。145例(45.5%)患者年龄≥60岁。其中，中度SUI 155例(48.6%)，重度SUI 164例(51.4%)，高血压96例(30.1%)，糖尿病24例(7.5%)，未生育2例(0.6%)，多产317例(99.4%)。31例(9.7%)伴有盆腔器官脱垂伴POP-Q 2期及以上。最大尿流率为5.2 ~ 72.6 ml/s。膀胱容量范围为56.7- 1013.6 ml，术前ICIQ-SF评分平均为13.9(范围9-19)。结果288例TVT-O手术时间为19 ~ 60 min, 31例膀胱内翻伴手术时间为50 ~ 120 min。265例可评价患者随访12 ~ 24个月，客观治愈率为95.8%(254例)，主观治愈率为93.6%(248例)。根治率96.8%。术后并发症为腹股沟疼痛10.6%，急症4.5%，其他包括尿路感染(3.4%)，新发排尿困难(2.6%)，性交困难(1.1%)，膀胱损伤1例，吊带糜烂1例，瘢痕增生1例。结论女性压力性尿失禁主要发生在心理生活质量严重的中老年人中，持续数年。TVT-O治疗成功率高，改良率高，无严重不良反应。一次手术可以纠正应激性尿失禁，同时纠正脱垂。关键词:尿失禁;压力;临床特征;无张力阴道带

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Retrospective analysis clinical characteristics of female stress urinary incontinence and efficacy of transobturator tension-free vaginal tape procedure

Objective To explore the clinical characteristics of patients with female stress urinary incontinence(SUI) and efficacy of Transobturator Tension-free vaginal tape procedure. Methods We retrospectively analyzed the clinical data of 319 cases who were operated transobturator tension free vaginal tape in Shanghai Changhai Hospital Affiliated of Naval Medical University from Oct.2009 to Jun.2018. Patients age ranged from 39 to 91 years old, with the average age of(59.2±9.7)years old. 145(45.5%) patients aged ≥60 years old. Among them, 155 (48.6%) patients with moderate SUI, 164(51.4%) with severe SUI.96 cases(30.1%) hypertension, 24(7.5%)diabetes, 2(0.6%)had not given birth, 317(99.4%)patients had given birth more than once. 31(9.7%) coexisting pelvic organ prolapse with POP-Q stage 2 and above. Maximum urinary flow rate ranged 5.2-72.6 ml/s. Cystometric capacity ranged 56.7-1 013.6 ml. Average preoperative ICIQ-SF score was 13.9 (range 9-19). Results Operative time of 288 TVT-O procedures ranged 19-60 min, and 31 cases in the surgical management of cystocele with concomitant ranged 50-120 min. A total of 265 patients were evaluable followed up for 12-24 months, Objective cure rate and subjective cure rate were achieved in 95.8%(254 cases) and 93.6%(248 cases) respectively. POP was cured in 96.8% patients.Postoperative complications were 10.6% groin pain, 4.5% urgency, others including urinary tract infection(3.4%), de novo dysuresia(2.6%), dyspareunia(1.1%), and one case of bladder injury, one case sling erosion and one case scar hyperplasia. Conclusions Female stress urinary incontinence were mainly in middle-aged and elderly people who had severely psychological quality of life lasting for several years. TVT-O may achieve a high success or improvement rate and no serious adverse effects. One operation could correct the stress urinary incontinence and simultaneously correct prolapse. Key words: Urinary incontinence, stress; Clinical features; Transobturator tension-free vaginal tape

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.