Lin Long-Yau, Sheu Bor-Ching, Lin Ho-Hsiung
Department of Obstetrics and Gynecology, Chung-Shan Medical University, Taichung, Taiwan.
Eur Urol. 2004 Mar;45(3):362-6; discussion 366. doi: 10.1016/j.eururo.2003.11.003.
To sequentially compare the urodynamic findings in patients with genuine stress incontinence (GSI) before and after tension-free vaginal tape (TVT) operation.
Between January 2001 and January 2002, 24 consecutive patients with GSI who completed multi-channel urodynamic study and 20-minute pad test before operation and at 3, 6, and 12 months after operation were enrolled. The sequential urodynamic findings of each case were compared and analyzed.
The mean age of the 24 patients was 60.6+/-10.7 years with the parity of 3.5+/-1.4. No statistical differences in voiding and storage functions before and after TVT operation were noted. In contrast, significant changes of stress urethral pressure profile (sUPP) including maximal urethral pressure, maximal urethral closure pressure, functional urethral length, urethral closure area and continence area were observed at 6 and 12 months postoperatively ( p<0.03 ). The median pad weight test decreased from 72g (range 10-220) to 0g 3 months after operation and remained unchanged at 6 and 12 months postoperatively.
This prospective study demonstrates that TVT operation, if done properly, does not significantly impair voiding and storage functions. The significantly increased sUPP parameters may contribute, at least in part, to the high cure rate of TVT operation.
序贯比较无张力阴道吊带术(TVT)手术前后真性压力性尿失禁(GSI)患者的尿动力学检查结果。
2001年1月至2002年1月期间,连续纳入24例完成多通道尿动力学检查及术前、术后3个月、6个月和12个月20分钟护垫试验的GSI患者。对每例患者的序贯尿动力学检查结果进行比较和分析。
24例患者的平均年龄为60.6±10.7岁,平均产次为3.5±1.4次。TVT手术后排尿和储尿功能无统计学差异。相比之下,术后6个月和12个月时,压力性尿道压力分布(sUPP)出现显著变化,包括最大尿道压力、最大尿道闭合压力、功能性尿道长度、尿道闭合面积和控尿面积(p<0.03)。术后3个月护垫重量试验中位数从72g(范围10 - 220)降至0g,术后6个月和12个月保持不变。
这项前瞻性研究表明,TVT手术如果操作得当,不会显著损害排尿和储尿功能。sUPP参数显著增加可能至少部分促成了TVT手术的高治愈率。