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无张力阴道吊带手术后的排尿模式与尿动力学

Voiding patterns and urodynamics after a tension-free vaginal tape procedure.

作者信息

Al-Badr Ahmed, Ross Sue, Soroka Dana, Minassian Vatche A, Karahalios Amalia, Drutz Harold P

机构信息

Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

出版信息

J Obstet Gynaecol Can. 2003 Sep;25(9):725-30. doi: 10.1016/s1701-2163(16)31001-5.

Abstract

OBJECTIVE

To evaluate changes in urodynamic parameters, therapeutic success, and complication rates after a tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence (SUI).

METHODS

Sixty-three women who underwent a TVT procedure for SUI, between June 1999 and December 2001 at Mount Sinai Hospital in Toronto, Ontario, were prospectively followed. Pre- and postoperative clinical data were analyzed using the Mann-Whitney, chi-square, paired t-test, and Wilcoxon signed ranks tests.

RESULTS

The range of follow-up was 6 weeks to 3 years. Short-term voiding dysfunction occurred in 49% of the women but was completely resolved in all women by the 12-week follow-up. For the 45 women who completed their follow-up at 6 months or 1 year after TVT, the success rate was 85%. Provocative urodynamics at 1-year follow-up compared to preoperative data showed a decrease in maximum flow rate (P < 0.001), and increase in post-void residual urine volume (P < 0.001).

CONCLUSION

TVT is associated with a good short-term success rate at 6 months and 1 year. A low long-term complication rate and morbidity may be expected, but significant temporary voiding dysfunction, higher than previously reported, was observed.

摘要

目的

评估压力性尿失禁(SUI)女性患者接受无张力阴道吊带术(TVT)后尿动力学参数的变化、治疗成功率及并发症发生率。

方法

前瞻性随访了1999年6月至2001年12月期间在安大略省多伦多市西奈山医院接受TVT手术治疗SUI的63名女性患者。采用Mann-Whitney检验、卡方检验、配对t检验和Wilcoxon符号秩检验对术前和术后临床数据进行分析。

结果

随访时间为6周至3年。49%的女性出现短期排尿功能障碍,但在12周随访时所有女性的排尿功能障碍均完全缓解。对于45名在TVT术后6个月或1年完成随访的女性,成功率为85%。与术前数据相比,1年随访时的激发性尿动力学检查显示最大尿流率降低(P < 0.001),残余尿量增加(P < 0.001)。

结论

TVT在6个月和1年时具有良好的短期成功率。预计长期并发症发生率和发病率较低,但观察到明显的暂时性排尿功能障碍,高于先前报道。

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