Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
J Minim Invasive Gynecol. 2013 Jul-Aug;20(4):455-9. doi: 10.1016/j.jmig.2013.01.006. Epub 2013 Mar 15.
To investigate whether patient quality of life and sexual function are improved after the tension-free vaginal tape SECUR (TVT-S) procedure (H-type).
Prospective study (Canadian Task Force classification II-3).
Single-center hospital.
Thirty-three women with stress urinary incontinence (SUI) (high urethral mobility) and no concomitant pelvic floor prolapse underwent TVT-S between October 2009 and October 2011.
TVT-S procedure.
Before and after surgery(6 and 12 months), all patients completed the Chinese version of the Incontinence Quality of Life Questionnaire (I-QOL). In addition, 28 sexually active patients who underwent the TVT-S procedure completed the short-form Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) before and after surgery (6 and 12 months). We used a paired t test to compare I-QOL scores before and after surgery. The Wilcoxon signed-rank test was used to compare the preoperative and postoperative PISQ scores. The objective cure rate was 78% (26 of 33 patients) at 12 months after surgery. The objective improvement rate was 12.1% (4 of 33 patients). The subjective satisfaction rate was 90%. Three operations (9.1%) were considered failures. Two patients underwent a TVT procedure after TVT-S because of recurrence. No patients reported severe pain; the mean (SD) visual analog scale pain score was 1.8 (1.2) after surgery. Only 1 patient (3%) was found to have sling erosion at 12 months postoperatively. The I-QOL score was 28.3 (14.2) before surgery and increased to 69.5 (18.9) at 12 months after the TVT-S procedure. The I-QOL score improved significantly after surgery (p <.001). The total PISQ-12 score at 6 months after surgery in all sexually active patients was 33.82 (0.87), compared with 31.57 (1.20) before surgery (p <.05). Physical domain scores on the PISQ-12 demonstrated significant improvement, increasing from 12.61 (0.75) to 14.36 (0.49) (p <.05). No significant difference was found between I-QOL and PISQ-12 scores at 6 and 12 months after surgery. There was no significant difference in total PISQ-12 scores in premenopausal patients before and after surgery (p >.05).
Although the objective cure rate was not high, the TVT-S procedure is a minimally invasive, safe, and effective surgical procedure for treatment of SUI (high urethral mobility) and can improve the quality of life and sexual function in women with SUI.
探讨经阴道无张力悬吊带 SECUR（TVT-S）术（H 型）治疗后患者生活质量和性功能是否得到改善。
前瞻性研究（加拿大卫生研究院分级 II-3 级）。
单中心医院。
2009 年 10 月至 2011 年 10 月期间，33 例压力性尿失禁（SUI）（尿道高移动度）且无合并盆腔器官脱垂的女性患者接受了 TVT-S 术。
TVT-S 术。
所有患者在术前和术后（6 个月和 12 个月）均完成了中文版尿失禁生活质量问卷（I-QOL）。此外，28 例接受 TVT-S 术的有性生活史的患者在术前和术后（6 个月和 12 个月）完成了简短型盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）。我们采用配对 t 检验比较手术前后 I-QOL 评分。采用 Wilcoxon 符号秩检验比较术前和术后 PISQ 评分。12 个月时的客观治愈率为 78%（33 例患者中的 26 例）。客观改善率为 12.1%（33 例患者中的 4 例）。主观满意度为 90%。3 例手术（9.1%）被认为失败。2 例患者因复发接受了 TVT 术。无患者报告严重疼痛；术后平均（SD）视觉模拟量表疼痛评分 1.8（1.2）。仅 1 例患者（3%）在术后 12 个月发现吊带侵蚀。I-QOL 评分术前为 28.3（14.2），TVT-S 术后 12 个月增至 69.5（18.9）。术后 I-QOL 评分显著改善（p<0.001）。所有有性生活史的患者术后 6 个月的总 PISQ-12 评分为 33.82（0.87），术前为 31.57（1.20）（p<0.05）。PISQ-12 的生理领域评分显著改善，从 12.61（0.75）增加到 14.36（0.49）（p<0.05）。术后 6 个月和 12 个月时，I-QOL 和 PISQ-12 评分之间无显著差异。术前和术后，绝经前患者的总 PISQ-12 评分无显著差异（p>0.05）。
尽管客观治愈率不高，但 TVT-S 术是一种微创、安全且有效的治疗 SUI（尿道高移动度）的手术方法，可改善 SUI 女性的生活质量和性功能。
