Wang Q, Ke H, Ding Z, Zhang W, Zhang X, Xu T, Xu K
Department of Urology, Peking University People' s Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Aug 18;57(4):717-720. doi: 10.19723/j.issn.1671-167X.2025.04.014.
To compare the changes of maximun flow rate and residual urine volume after tension-free vaginal tape (TVT) and trans-obturator tape (TOT) in the treatment of stress urinary incontinence in women.
The clinical data of female patients with stress urinary incontinence who underwent transvaginal midsection tension-free urethral suspension in Peking University People' s Hospital from January 2022 to January 2024 were retrospectively analyzed. All the patients were followed up 1 month, 6 months and 12 months after surgery. Urodynamics were performed to evaluate urethral sphincter function before surgery. At the same time, B-ultrasonography was improved to determine the residual urinary volume of the bladder, and urgent incontinence, detrusor weakness and bladder outlet obstruction were excluded, and the diagnosis was clearly stress incontinence. Maximum flow rate and residual urinary volume were measured during follow-up, and combined with the urinary incontinence questionnaire of the International Urinary Incontinence Advisory Committee, the surgical effect was judged to be cured, improved or ineffective according to the degree of improvement of urinary leakage symptoms after surgery.
A total of 150 female patients with stress urinary incontinence were included in the study, the average age of the patients was (55.12±10.23) years old, and the follow-up time was 12 months. All patients completed postoperative follow-up, of whom 60 underwent TVT and 90 underwent TOT. The overall effective rates (cure + improvement) 1, 6, and 12 months after surgery in the TVT group were 93.3% (56/60), 91.7% (55/60), and 91.7% (55/60), and those in the TOT group were 92.2% (83/90), 90.0% (81/90), 90.0% (81/90), respectively, and there was no statistical difference between the two groups. The average maximum urinary flow rates 1, 6, and 12 months after surgery in the TVT group were (17.21±4.22) mL/s, (18.05±5.33) mL/s, and (18.37±4.92) mL/s, and those in the TOT group were (18.21±5.32) mL/s, (19.05±4.33) mL/s, and (19.27±4.92) mL/s, respectively, and there was no statistical difference between the two groups. The mean residual urine volume 1, 6, and 12 months after surgery in the TVT group was (13.21±5.22) mL, (18.25±5.33) mL, and (16.37±7.92) mL, and those in the TOT group was (11.21±6.32) mL, (13.05±5.33) mL, and (11.27±5.92)mL, respectively, and there was no statistical difference between the two groups. Compared with preoperative levels, there were no significant differences in the average maximum flow rate and the residual urine volume in both group at 1, 6, and 12 months after surgery.
Both TVT and TOT are effective in the treatment of stress incontinence, and have no effect on postoperative maximum flow rate and residual urine volume.
比较无张力阴道吊带术（TVT）和经闭孔无张力阴道吊带术（TOT）治疗女性压力性尿失禁后最大尿流率和残余尿量的变化。
回顾性分析2022年1月至2024年1月在北京大学人民医院行经阴道中段无张力尿道悬吊术的女性压力性尿失禁患者的临床资料。所有患者术后1个月、6个月和12个月进行随访。术前进行尿动力学检查以评估尿道括约肌功能。同时，行B超检查以测定膀胱残余尿量，排除急迫性尿失禁、逼尿肌功能不全和膀胱出口梗阻，明确诊断为压力性尿失禁。随访期间测量最大尿流率和残余尿量，并结合国际尿失禁咨询委员会尿失禁问卷，根据术后漏尿症状改善程度判断手术效果为治愈、改善或无效。
共纳入150例女性压力性尿失禁患者，患者平均年龄（55.12±10.23）岁，随访时间12个月。所有患者均完成术后随访，其中60例行TVT，90例行TOT。TVT组术后1个月、6个月和12个月的总有效率（治愈+改善）分别为93.3%（56/60）、91.7%（55/60）和91.7%（55/60），TOT组分别为92.2%（83/90）、90.0%（81/90）、90.0%（81/90），两组间差异无统计学意义。TVT组术后1个月、6个月和12个月的平均最大尿流率分别为（17.21±4.22）mL/s、（18.05±5.33）mL/s和（18.37±4.92）mL/s，TOT组分别为（18.21±5.32）mL/s、（19.05±4.33）mL/s和（19.27±4.92）mL/s，两组间差异无统计学意义。TVT组术后1个月、6个月和12个月的平均残余尿量分别为（13.21±5.22）mL、（18.25±5.33）mL和（16.37±7.92）mL，TOT组分别为（11.21±6.32）mL、（13.05±5.33）mL和（11.27±5.92）mL，两组间差异无统计学意义。与术前水平相比，两组术后1个月、6个月和12个月的平均最大尿流率和残余尿量均无显著差异。
TVT和TOT治疗压力性尿失禁均有效，且对术后最大尿流率和残余尿量无影响。
