Lukacz Emily S, Luber Karl M, Nager Charles W
Female Pelvic Medicine and Reconstructive Surgery, UCSD Department of Reproductive Medicine, 200 West Arbor Drive, #8433, San Diego, CA 92103, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2003 Aug;14(3):179-84; discussion 184. doi: 10.1007/s00192-003-1058-z. Epub 2003 Apr 26.
This study was designed to determine the anatomic effects of the tension-free vaginal tape (TVT). A cohort of 94 patients was followed for 1 year. Urethral position was quantified using the Q-tip angle. Statistical analysis employed the ANOVA and paired t tests. A total of 54 (57%) patients met the criteria for analysis. In these 54 patients the success rate was 81%. Straining Q-tip angles decreased from a mean preoperative value of 52 degrees to 28 degrees before 1 month, 34 degrees at 1-6 months, 41 degrees at 6-12 months, and 45 degrees at 1 year ( P <0.05). The postoperative resting angles remained essentially unchanged. The sling initially provides support to the proximal urethra which diminishes over time. Unchanged resting Q-tip angles confirm the tension-free concept and there appears to be no shrinkage or tightening of the sling. We concluded that the success of the TVT is not due to proximal urethral support.
本研究旨在确定无张力阴道吊带术（TVT）的解剖学效果。对94例患者进行了为期1年的随访。采用棉签角度对尿道位置进行量化。统计分析采用方差分析和配对t检验。共有54例（57%）患者符合分析标准。在这54例患者中，成功率为81%。用力时棉签角度从术前平均52度降至1个月前的28度、1 - 6个月时的34度、6 - 12个月时的41度以及1年时的45度（P <0.05）。术后静息角度基本保持不变。吊带最初为近端尿道提供支撑，随着时间推移这种支撑作用逐渐减弱。静息棉签角度不变证实了无张力的概念，且吊带似乎没有收缩或收紧。我们得出结论，TVT的成功并非归因于近端尿道支撑。
