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经闭孔无张力尿道中段吊带术(TVT-Exact)与传统尿道中段吊带术(SLING-IUFT)的手术操作:一项随机研究。

TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study.

作者信息

Aniuliene Rosita, Aniulis Povilas, Skaudickas Darijus

机构信息

Lithuanian University of Health Sciences, Mickeviciaus str.9, Kaunas, LT-44307, Lithuania, Tel. +37068778631.

Clinic of Urology, Lithuanian University of Health Sciences, Lithuania.

出版信息

Open Med (Wars). 2015 Jun 10;10(1):311-317. doi: 10.1515/med-2015-0046. eCollection 2015.

Abstract

OBJECTIVES

The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI).

METHODS

A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients - using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II).

RESULTS

Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact - at 94.5% and SLING-IUFT - at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group.

CONCLUSION

the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness.

摘要

目的

本研究旨在比较经闭孔无张力尿道中段吊带术(TVT-Exact)和经阴道尿道中段吊带术(SLING-IUFT)治疗女性压力性尿失禁(SUI)的结果、有效性及并发症。

方法

2009年4月至2011年4月,由一名外科医生对患有SUI的女性进行了一项单中心、非盲法随机研究,将患者随机分为TVT-Exact组和SLING-IUFT组。通过咳嗽和瓦尔萨尔瓦试验诊断SUI,并在手术前及术后1年评估尿动力学(膀胱测压和尿流率测定)。这是一项前瞻性随机研究。随访期为12个月。76例患者接受了TVT-Exact手术,78例患者接受了SLING-IUFT手术。两组在体重指数、产次、绝经状态和脱垂分期方面无统计学显著差异(无患者膀胱膨出大于II期)。

结果

SLING-IUFT组的平均手术时间(19±5.6分钟)明显短于TVT-Exact组(27±7.1分钟)。两种手术的有效性存在统计学显著差异:TVT-Exact组术后一年有效率为94.5%,SLING-IUFT组为61.2%。SLING-IUFT组的住院时间(1.2±0.5天)明显短于TVT-Exact组(3.5±1.5天)。SLING-IUFT组发生的并发症在统计学上明显较少。

结论

TVT-Exact和SLING-IUFT手术在女性压力性尿失禁的手术治疗中均有效。SLING-IUFT手术时间较短,并发症发生率较低。TVT-Exact手术的并发症在统计学上明显多于SLING-IUFT手术,但有效性更高。

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