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[使用无张力阴道吊带的外科手术——一种治疗压力性尿失禁的安全方法?]

[Surgical procedure using the tension-free vaginal tape--a safe method for treatment of stress incontinence?].

作者信息

Chmel R

机构信息

Gynekologicko-porodnická klinika UK 2. LF a FN v Motole.

出版信息

Ceska Gynekol. 2003 May;68(3):143-7.

Abstract

OBJECTIVE

An importance of knowledge of intraoperative and postoperative complications of tension-free vaginal tape procedure (TVT) in the treatment of female stress urinary incontinence.

DESIGN

A review article.

SETTING

Obstetrics and Gynecology Department, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Prague.

SUBJECT

Complications connected with TVT procedure are classified as intraoperative and postoperative. Postoperative complications are divided into early and late. Bladder perforation is the most common type of intraoperative complication with 0-24% frequency. Hemorrhage (less then 2%) and injury of the obturator nerve (published as case reports only) belong among other intraoperative complications. Voiding difficulties with urinary retention and urge incontinence (about 7%), urinary tract infections (about 4%) and retropubic hematoma (less than 2%) are most frequent postoperative complications. Intestinal perforation, urethral erosion, tape rejection and urethrovaginal fistula belong among very rare but serious complications of TVT procedure. Complications rate relates partly to the experience of the individual surgeon.

CONCLUSION

The tension-free vaginal tape procedure is a safety and effective antiincontinent surgical procedure. High cure rate, low complications rate and short recovery time facilitates this procedure for treatment of stress urinary incontinence to the future.

摘要

目的

了解无张力阴道吊带术(TVT)治疗女性压力性尿失禁术中及术后并发症的重要性。

设计

一篇综述文章。

单位

布拉格查理大学第二医学院妇产科及Motol大学医院。

研究对象

与TVT手术相关的并发症分为术中并发症和术后并发症。术后并发症又分为早期和晚期。膀胱穿孔是最常见的术中并发症类型,发生率为0 - 24%。出血(少于2%)和闭孔神经损伤(仅以病例报告形式发表)属于其他术中并发症。排尿困难伴尿潴留和急迫性尿失禁(约7%)、尿路感染(约4%)和耻骨后血肿(少于2%)是最常见的术后并发症。肠穿孔、尿道侵蚀、吊带排斥和尿道阴道瘘属于TVT手术非常罕见但严重的并发症。并发症发生率部分与手术医生的经验有关。

结论

无张力阴道吊带术是一种安全有效的抗尿失禁手术。高治愈率、低并发症发生率和短恢复时间使该手术在未来治疗压力性尿失禁方面具有优势。

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