Kuuva Nina, Nilsson Carl Gustaf
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, FIN-00029 HUS, Helsinki, Finland.
Acta Obstet Gynecol Scand. 2002 Jan;81(1):72-7. doi: 10.1034/j.1600-0412.2002.810113.x.
To evaluate the therapy-associated morbidity of all patients who underwent a TVT operation in Finland by the end of the year 1999.
Questionnaires on the number of operations and on the number of different complications were sent to 38 hospitals where TVT operations had been independently performed after an obligatory TVT training period. The primary TVT training center and a hospital, which did not use the standard TVT equipment, were excluded.
Among the 38 hospitals there were four university, 13 central and 21 local hospitals. The total number of operations was 1455. The incidence of bladder perforation was 38/1000, that of intra-operative blood loss over 200 ml 19/1000, of major vessel injury 0.7/1000, of nerve injury 0.7/1000, of vaginal hematoma 0.7/1000 and of urethral lesion 0.7/1000. The incidence of minor voiding difficulty was 76/1000, that of urinary tract infection 41/1000, of complete postoperative urinary retention 23/1000, of retropubic hematoma 19/1000, of wound infection 8/1000 and of vaginal defect healing 7/1000. No case of tape rejection or life threatening complication occurred and the incidence of complications requiring laparotomy was 3.4/1000. The ratio of number of complications to TVT operations performed did not vary significantly between different hospital types (p>0.05).
The TVT procedure is a safe method for the treatment of stress urinary incontinence provided that appropriate training is offered.
评估截至1999年底在芬兰接受经阴道无张力尿道中段悬吊带术（TVT）的所有患者的治疗相关发病率。
向38家医院发送了关于手术数量和不同并发症数量的调查问卷，这些医院在经过强制性TVT培训期后独立开展了TVT手术。主要的TVT培训中心和一家未使用标准TVT设备的医院被排除在外。
38家医院中，有4家大学医院、13家中心医院和21家地方医院。手术总数为1455例。膀胱穿孔发生率为38/1000，术中失血超过200 ml的发生率为19/1000，大血管损伤发生率为0.7/1000，神经损伤发生率为0.7/1000，阴道血肿发生率为0.7/1000，尿道病变发生率为0.7/1000。轻微排尿困难发生率为76/1000，尿路感染发生率为41/1000，术后完全尿潴留发生率为23/1000，耻骨后血肿发生率为19/1000，伤口感染发生率为8/1000，阴道缺损愈合发生率为7/1000。未发生吊带排斥或危及生命的并发症病例，需要剖腹手术的并发症发生率为3.4/1000。不同医院类型之间，并发症数量与TVT手术数量的比值无显著差异（p>0.05）。
只要提供适当的培训，TVT手术是治疗压力性尿失禁的一种安全方法。
