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无张力阴道吊带术治疗女性压力性尿失禁的5年随访研究结果

Results of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence: a 5-year follow-up study.

作者信息

Celebi Ibrahim, Güngördük Kemal, Ark Cemal, Akyol Alpaslan

机构信息

Department of Obstetrics and Gynecology, Women and Children Hospital, Istanbul, Turkey.

出版信息

Arch Gynecol Obstet. 2009 Apr;279(4):463-7. doi: 10.1007/s00404-008-0805-2. Epub 2008 Sep 18.

Abstract

OBJECTIVE

We evaluated the long-term cure rates, surgical complications rates after treatment of urodynamically confirmed primary genuine stress incontinence with tension-free vaginal tape (TVT).

METHODS

We performed a retrospective review of all patients undergoing the TVT procedure over a 5-year period to report intraoperative complication, postoperative complications and subjective cure rates.

RESULTS

TVT was performed on 600 patients under general anesthesia. Among these patients, 563 were followed up for least 5 years; the remaining 47 patients could not be followed up. The mean follow-up interval was 63.1+/-3.1 (range 60-70) months. The mean age of the women was 51.7+/-11.6 years and mean body mass index 31.7+/-3.0 kg/m(2). Sixty-two percent (347) of women underwent the TVT procedure in conjunction with other vaginal surgery, and 38% (216) underwent TVT alone. The subjective analysis of the effect of surgery on the symptom of GSI was that, overall, 86.7% were completely cured, 6.0% were significantly improved and 7.3% found no change in the severity of her incontinence. No major nerve or vessel injury occurred, but 17 patients (3.0%) incurred bladder injury during the surgery. De novo voiding urgency occurred in 36 patients (6.4%). Thirty patients (5.3%) developed voiding problem, of which 19 patients had short-term voiding problem.

CONCLUSION

The TVT procedure is a relatively safe and effective, minimally invasive surgical technique for the treatment of female urinary stress incontinence.

摘要

目的

我们评估了经尿动力学证实的原发性真性压力性尿失禁患者采用无张力阴道吊带术(TVT)治疗后的长期治愈率及手术并发症发生率。

方法

我们对5年内接受TVT手术的所有患者进行了回顾性研究,以报告术中并发症、术后并发症及主观治愈率。

结果

600例患者在全身麻醉下接受了TVT手术。其中,563例患者至少随访了5年;其余47例患者未能进行随访。平均随访时间为63.1±3.1(范围60 - 70)个月。女性患者的平均年龄为51.7±11.6岁,平均体重指数为31.7±3.0kg/m²。62%(347例)的女性在接受TVT手术的同时还进行了其他阴道手术,38%(216例)仅接受了TVT手术。对手术治疗GSI症状效果的主观分析显示,总体上,86.7%的患者完全治愈,6.0%的患者明显改善,7.3%的患者失禁严重程度无变化。术中未发生重大神经或血管损伤,但17例患者(3.0%)在手术中发生膀胱损伤。36例患者(6.4%)出现新发排尿急迫感。30例患者(5.3%)出现排尿问题,其中19例患者存在短期排尿问题。

结论

TVT手术是一种治疗女性压力性尿失禁相对安全、有效且微创的外科技术。

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