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[第三代尿道中段下置网片:110例TVT-SECUR手术的经验]

[Third generation sub-mid urethral mesh: experience with 110 TVT-SECUR].

作者信息

Solà Vicente, Ricci Paolo, Pardo Jack

机构信息

Unidad de Uroginecología y Cirugía Vaginal, Departamento de Obstetricia y Ginecología, Clínica Las Condes, Las Condes, Santiago de Chile.

出版信息

Arch Esp Urol. 2009 Jun;62(5):376-86; discussion 386-8. doi: 10.4321/s0004-06142009000500007.

Abstract

OBJECTIVES

To review the effectiveness and security of the TVT-Secur system in the surgical treatment of stress urinary incontinence(SUI).

METHODS

Prospective analysis of 110 patients undergoing SUI surgical treatment in the Urogynecology and Vaginal Surgery Unit of Clínica Las Condes, between January 2007 and May 2008. The patients must have stress urinary incontinence over one year or more. They must not have history of a previous surgery for urinary incontinence or prolapse. They must not have mixed monstrated by clinical symptoms and non-multichannel urodynamic study.

RESULTS

Mean surgical time was 8 minutes (6 to 16 minutes). The observational period was between 2 months (4 cases) and 19 months, mean 8 months. During the intraoperative time 2 cases of bladder perforation were registered. In the immediate postoperative time 2 cases of obstruction were observed. In 97 (88,2%) of the 110 patients some concomitant gynecological surgery was performed. In 105 (95,5%) of the 110 cases cure of the SUI was registered. In 4 (3,6%) cases improvement was observed and 1 (0,9%) case was a failure. In 2 (1,8%) patients de novo urge incontinence was registered.

CONCLUSIONS

The TVT-Secur system corresponds to a third generation tape effective and safe in the surgical treatment of stress urinary incontinence. This technique has potential advantages when compared with the preceding operations. Only the long time follow-up and incorporation of new patients will allow to determine the permanence of these good results in the time.

摘要

目的

回顾TVT-Secur系统在压力性尿失禁(SUI)手术治疗中的有效性和安全性。

方法

对2007年1月至2008年5月间在拉斯孔德斯诊所泌尿妇科和阴道外科接受SUI手术治疗的110例患者进行前瞻性分析。患者必须有一年或更长时间的压力性尿失禁。他们不能有既往尿失禁或盆腔器官脱垂手术史。通过临床症状和多通道尿动力学研究未证实有混合性尿失禁。

结果

平均手术时间为8分钟(6至16分钟)。观察期为2个月(4例)至19个月,平均8个月。术中记录到2例膀胱穿孔。术后即刻观察到2例梗阻。110例患者中有97例(88.2%)同时进行了一些妇科手术。110例中有105例(95.5%)SUI治愈。4例(3.6%)观察到改善,1例(0.9%)失败。2例(1.8%)患者出现新发急迫性尿失禁。

结论

TVT-Secur系统是一种有效且安全的第三代吊带,用于压力性尿失禁的手术治疗。与之前的手术相比,该技术具有潜在优势。只有长期随访和纳入新患者才能确定这些良好结果在时间上的持久性。

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