Mazouni Chafika, Karsenty Gilles, Bretelle Florence, Bladou Franck, Gamerre Marc, Serment Gerard
Urology Department, Salvator Hospital, Marseille, France.
Acta Obstet Gynecol Scand. 2004 Oct;83(10):955-61. doi: 10.1111/j.0001-6349.2004.00524.x.
The purpose of this prospective study was to evaluate urinary and sexual function after the tension-free vaginal tape (TVT) support procedure for stress urinary incontinence (SUI).
Between January 1999 and July 2002 a total of 71 patients underwent comprehensive examination including urodynamics and a mailed self-administered questionnaire for assessment of voiding and sexual function before and after treatment of SUI by TVT.
Based on objective findings TVT was considered as curative in 48 patients (87.3%). Comparison of preoperative and postoperative urodynamic evidence demonstrated a significant outflow obstruction (<12 ml/s) in 19 patients (34.5%). A significant decrease in peak urinary flow during voiding (p < 0.001) was also observed. Of the 55 women (78.5%) who responded to the questionnaire before and after TVT, 42 (76.3%) reported satisfaction with the outcome. Postoperatively, 60% of patients reported voiding difficulty, 47.2% complained of urgency, and 32.7% of frequency. Regarding sexual function 20% reported impairment after surgery including dyspareunia in 14.5% (none preoperatively vs. eight postoperatively, <0.01) and loss of libido in 5.4%.
The TVT procedure is an effective treatment for SUI. However, it can lead to postoperative voiding and sexual impairment.
本前瞻性研究旨在评估无张力阴道吊带术（TVT）治疗压力性尿失禁（SUI）后的泌尿及性功能。
1999年1月至2002年7月，共有71例患者接受了全面检查，包括尿动力学检查以及一份邮寄的自我管理问卷，以评估TVT治疗SUI前后的排尿和性功能。
根据客观检查结果，48例患者（87.3%）的TVT治疗被认为有效。术前和术后尿动力学证据比较显示，19例患者（34.5%）存在明显的流出道梗阻（<12 ml/s）。排尿时的最大尿流率也显著降低（p < 0.001）。在TVT前后回复问卷的55名女性（78.5%）中，42名（76.3%）对结果表示满意。术后，60%的患者报告有排尿困难，47.2%的患者抱怨尿急，32.7%的患者有尿频。关于性功能，20%的患者报告术后有功能障碍，包括性交困难的占14.5%（术前无，术后8例，<0.01），性欲减退的占5.4%。
TVT手术是治疗SUI的有效方法。然而，它可能导致术后排尿和性功能障碍。
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