[腹腔镜Burch阴道悬吊术与无张力阴道吊带术治疗女性压力性尿失禁的疗效比较研究]

[Effects of laparoscopic Burch colposuspension and tension-free vaginal tape in treatment of female stress urinary incontinence: a comparative study].

作者信息

Tong Jia-li, Zhu Lan, Lang Jing-he

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Dec 9;88(45):3192-4.

PMID:19171091

Abstract

OBJECTIVE

To evaluate the efficacy and complications of laparoscopic Burch colposuspension and tension-free vaginal tape (TVT) in treatment of female stress urinary incontinence (SUI).

METHODS

Thirty patients underwent laparoscopic Burch colposuspension and 67 age, BMI, parity, and grading-matched patients underwent TVT because of moderate to severe hypermotility urodynamic SUI from 2002 to 2006. Follow-up was conducted for (9 +/- 10) months. The clinical characteristics, mean operation time, hospital stay, peri-operative complications, and late complications were compared.

RESULTS

The mean operative time and the hospital stay of the TVT group was (29.57 +/- 8.23) min and (3.0 +/- 2.1) d, both significantly shorter than those of the Burch operation group [(87 +/- 23) min and (4.8 +/- 1.9) d respectively, P < 0.001 and P < 0.01]. The blood loss of the TVT group was (27 +/- 12) ml, significantly less than that of the Burch operation group [(59 +/- 30) ml, P < 0.001]. The subjective cure rate of the Burch operation group was 86.5%, not significantly different from that of the TVT group (95.5%, P > 0.05). Short-term complications included 1 case of bladder injury and 1 case of circumflex iliac vein injuring, both occurring in the Burch colposuspension group. The postoperative urine retention rate of the Burch colposuspension group was 23.5%, not significantly different from that of the TVT group (14.9%, P > 0.05), and the postoperative fever rate of the Burch colposuspension group was 16.2%, significantly higher than that of the TVT group (4.5%, P < 0.05). Three cases of erosion of sling were found in the TVT group as late complications.

CONCLUSION

Both Burch colposuspension and TVT are effective in the treatment of female SUI. The mean operative time of Burch operation and the hospital stay thereafter are longer; however, the cost of TVT is much higher than that of the Burch operation.

摘要

目的

评估腹腔镜下Burch阴道悬吊术和无张力阴道吊带术（TVT）治疗女性压力性尿失禁（SUI）的疗效及并发症。

方法

2002年至2006年，30例患者接受了腹腔镜下Burch阴道悬吊术，67例年龄、体重指数、产次和分级匹配的患者因中重度逼尿肌过度活动型尿动力学SUI接受了TVT手术。随访时间为（9±10）个月。比较两组的临床特征、平均手术时间、住院时间、围手术期并发症及远期并发症。

结果

TVT组的平均手术时间和住院时间分别为（29.57±8.23）分钟和（3.0±2.1）天，均显著短于Burch手术组[分别为（87±23）分钟和（4.8±1.9）天，P<0.001和P<0.01]。TVT组的失血量为（27±12）毫升，显著少于Burch手术组[（59±30）毫升，P<0.001]。Burch手术组的主观治愈率为86.5%，与TVT组（95.5%）无显著差异（P>0.05）。短期并发症包括1例膀胱损伤和1例旋髂静脉损伤，均发生在Burch阴道悬吊术组。Burch阴道悬吊术组的术后尿潴留率为23.5%，与TVT组（14.9%）无显著差异（P>0.05），Burch阴道悬吊术组的术后发热率为16.2%，显著高于TVT组（4.5%，P<0.05）。TVT组发现3例吊带侵蚀作为远期并发症。