无张力尿道中段悬吊术治疗女性混合性尿失禁的疗效分析

发布时间：2018-05-05 10:17

本文选题：压力性尿失禁 + 急迫性尿失禁　；参考：《北京大学学报(医学版)》2017年04期

【摘要】：目的:评估无张力尿道中段悬吊术治疗女性混合性尿失禁的中远期疗效。方法:随访分析2010年4月至2016年9月共26例无张力尿道中段悬吊术治疗女性混合性尿失禁患者的临床资料。26例随访到的患者中,4例采用经耻骨后无张力尿道中段悬吊术(retropubic tension free mid-urethral sling,TVT),22例采用经闭孔无张力尿道中段悬吊术(transurethral middle obturator sling,TOT)。术后中远期电话随访尿失禁严重程度评分(urinary incontinence severity score,UISS)、逼尿肌不稳定评分(detrusor instability score,DIS)、尿失禁生活质量量表评价(incontinence quality of life scale evaluation,I-QOL)、泌尿生殖障碍量表简版(Urogenital Distress Inventory short form,UDI-6),与术前评分进行比较分析。结果:26例患者年龄42~80岁,平均62岁。体重指数(body mass index,BMI)21.48~31.14 kg/m~2,平均26.82 kg/m~2。随访时间8~69个月,平均26个月,14例患者手术前曾服用M受体阻滞剂,但未超过2周。术中无膀胱损伤、尿道损伤、闭孔血管及神经损伤等并发症,术后拔除尿管时,患者均无局部疼痛或排尿困难。压力性尿失禁治愈25例,达96.15%,急迫性尿失禁治愈20例,达76.92%。26例随访患者生活质量较手术前显著改善(P0.05)。结论:无张力尿道中段悬吊术治疗女性混合性尿失禁总体有效率高,即使未长期服用M受体阻滞剂等药物,手术本身对急迫性尿失禁的治愈率达76.92%。手术的远期疗效稳定,患者生活质量能得到显著改善。
[Abstract]:Objective: to evaluate the mid-and long-term effect of tension-free middle-segment suspension in the treatment of female mixed urinary incontinence. Methods: from April 2010 to September 2016, 26 cases of female mixed urinary incontinence were treated by tension free midway suspension. 4 of 26 patients were treated with retropubic tension free middle urethra. Methods: from April 2010 to September 2016, a total of 26 cases of female mixed urinary incontinence were treated with tension free urethra. 22 cases of transurethral middle obturator slinging were performed with transurethral middle obturator slinging in 22 cases of transurethral middle obturator sling. After the middle and long term telephone follow-up, the scores of urinary incontinence severity, detrusor instability, urinary incontinence quality of life scale evaluation and UDI-6, Urogenital Distress Inventory short for UDI-6 were compared with those before operation. Results the age of 26 patients was 42 ~ 80 years (mean 62 years). The body mass index (BMI) is 21.48 kg / mm2, with an average of 26.82 kg / mm2. The follow-up time was 8 ~ 69 months, with an average of 26 months, 14 patients had taken M receptor blocker before operation, but not more than 2 weeks. There were no complications such as bladder injury, urethral injury, obturator vessel and nerve injury, and there was no local pain or dysuria. Stress urinary incontinence was cured in 25 cases (96.15), urgent urinary incontinence was cured in 20 cases, and quality of life was significantly improved in 76.92.26 cases compared with that before operation. Conclusion: the total effective rate of tension free middle urethral suspension in the treatment of female mixed urinary incontinence is high. Even if M receptor blockers are not taken for a long time, the cure rate of the operation itself for urgent urinary incontinence is 76.92. The long-term effect of the operation is stable and the quality of life of the patients can be improved significantly.
【作者单位】：北京大学人民医院泌尿外科;
【分类号】：R713

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