Guo Jing-Yang, An Feng, Gu De-Qiang, Yang Wenzeng
Jing-yang Guo, Department of Urology, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, P. R. China.
Feng An, Department of Urology, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, P. R. China.
Pak J Med Sci. 2020 Nov-Dec;36(7):1664-1670. doi: 10.12669/pjms.36.7.2619.
To observe the clinical significance of modified sling in the treatment of moderate stress urinary incontinence (SUI).
From January 2016 to January 2019, eighty patients with moderate urinary incontinence who were hospitalized in our hospital were randomly divided into two groups. 40 patients in the experimental group underwent modified sling transvaginal tension-free mid-urethral suspension. Modification method of the sling: cut the sling to a remaining length of about 6~7cm, properly connect the barbed sutures (V-LOCK) on both sides of the sling, and insert the urinary incontinence sling from the urethra to the obturator membrane, from the obturator membrane to the thigh. The inner skin area is replaced by the V-LOCK line. The 40 patients in the control group were unmodified ordinary slings. The operation time, the local pain of the inner thigh after the operation, and the improvement of postoperative urinary incontinence symptoms were compared and analyzed between the two groups.
Both groups of patients were successfully operated. The operation time was 16.36 minutes in the experimental group and 27.18 minutes in the control group. The difference in operation time between the two groups was statistically significant (p=0.00); the catheter was pulled out on the third day after the operation. One patient in the group had urinary effort, four patients still had urinary incontinence symptoms, the remaining 35 patients had good urinary control (effective rate 87.5%), five patients in the control group still had urinary incontinence, two patients had urinary effort, and the remaining 33 patients had urinary control Good, (effective rate 87.5%), there was no significant difference in surgical effectiveness between the two groups (p=0.53); follow-up for 12 to 36 months, no significant long-term complications occurred, the pain score of the inner thigh of the experimental group was significantly lower than that of the control group ,statistically significant (p=0.04).
The efficacy of the modified sling in the treatment of moderate SUI is the same as that of the traditional sling, but the operation time is shorter, the operation is simpler, and the local pain is significantly reduced.
观察改良吊带术治疗中度压力性尿失禁（SUI）的临床意义。
选取2016年1月至2019年1月在我院住院的80例中度尿失禁患者，随机分为两组。实验组40例患者行改良吊带经阴道无张力中段尿道悬吊术。吊带改良方法：将吊带裁剪至剩余长度约6～7cm，妥善连接吊带两侧的倒刺缝线（V-LOCK），将尿失禁吊带从尿道插入闭孔膜，从闭孔膜插入大腿。内侧皮肤区域用V-LOCK线替代。对照组40例患者采用未改良的普通吊带。比较分析两组患者的手术时间、术后大腿内侧局部疼痛情况及术后尿失禁症状改善情况。
两组患者手术均成功。实验组手术时间为16.36分钟，对照组为27.18分钟。两组手术时间差异有统计学意义（p = 0.00）；术后第3天拔除尿管。实验组1例患者有排尿费力，4例患者仍有尿失禁症状，其余35例患者控尿良好（有效率87.5%），对照组5例患者仍有尿失禁，2例患者有排尿费力，其余33例患者控尿良好，（有效率87.5%），两组手术效果差异无统计学意义（p = 0.53）；随访12至36个月，无明显远期并发症发生，实验组大腿内侧疼痛评分明显低于对照组，差异有统计学意义（p = 0.04）。
改良吊带术治疗中度SUI的疗效与传统吊带术相同，但手术时间短，操作更简单，局部疼痛明显减轻。
