经阴道无张力尿道中段悬吊术（TVT）和经闭孔无张力尿道中段悬吊术（TVT-O）治疗原发性压力性尿失禁的前瞻性随机试验。
TVT and TVT-O for surgical treatment of primary stress urinary incontinence: prospective randomized trial.
作者信息
Krofta Ladislav, Feyereisl Jaroslav, Otcenásek Michal, Velebil Petr, Kasíková Eva, Krcmár Michal
机构信息
Institute for the Care of Mother and Child, Podolske nabrezi 157, 147 00, Prague 4, Czech Republic.
出版信息
Int Urogynecol J. 2010 Feb;21(2):141-8. doi: 10.1007/s00192-009-1027-2. Epub 2009 Nov 12.
INTRODUCTION AND HYPOTHESIS
A study was conducted to compare the efficacy and complications of TVT and TVT-O.
METHODS
This study is a prospective randomized trial involving 300 women with primary SUI; 149 received TVT, and 151 patients were treated with TVT-O. At the 1 year follow-up, 141 TVT patients and 147 TVT-O patients (dropout, 5.3% and 2.6%) were evaluated using urodynamic studies, validated questionnaires, and a 1-h pad test.
RESULTS
The mean operating time was shorter in the TVT-O group (p < 0.001). Urinary retention was not significantly different (p > 0.05). Inner thigh discomfort was reported by 5.4% of TVT-O patients. In the TVT and the TVT-O groups, respectively, 90.1% and 88.4% women were objectively cured. The satisfaction with the surgical outcome reflects the significant decrease in the questionnaire mean symptom scores in both groups. Postoperative de novo urgency was significantly more common in the TVT-O patients (p = 0.015).
CONCLUSION
The groups showed comparable objective and subjective cure rates.
引言与假设
开展了一项研究以比较经阴道无张力尿道中段吊带术（TVT）和经闭孔无张力尿道中段吊带术（TVT - O）的疗效及并发症。
方法
本研究为前瞻性随机试验，纳入300例原发性压力性尿失禁女性；149例接受TVT，151例接受TVT - O治疗。在1年随访时，对141例TVT患者和147例TVT - O患者（失访率分别为5.3%和2.6%）进行尿动力学研究、有效问卷评估及1小时尿垫试验。
结果
TVT - O组平均手术时间较短（p < 0.001）。尿潴留无显著差异（p > 0.05）。5.4%的TVT - O患者报告有大腿内侧不适。TVT组和TVT - O组分别有90.1%和88.4%的女性获得客观治愈。对手术结果的满意度反映在两组问卷平均症状评分均显著降低。TVT - O患者术后新发尿急明显更常见（p = 0.015）。
结论
两组的客观和主观治愈率相当。
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