单切口可调节Ajust<sup>TM</sup>吊带治疗女性压力性尿失禁初步研究

张雪培; 任选义; 魏金星; 王智勇; 江雪霞; 刘建华

单切口可调节Ajust^TM吊带治疗女性压力性尿失禁初步研究

- 郑州大学第一附属医院泌尿外科(郑州, 450052)

详细信息

通讯作者: 张雪培,E-mail:zhangxuepei@263.net

中图分类号: R694

收稿日期: 2012-12-12

Initial study with the Ajust^TM system: a single incision adjustable sling for the treatment of female stress urinary incontinence

- Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China

More Information

Corresponding author: ZHANG Xuepei, E-mail: zhangxuepei@263.net

Received Date: 12 December 2012

摘要

摘要: 目的：评估Ajust^TM吊带手术治疗女性压力性尿失禁（SUI）的安全性和疗效。方法：2012年9~10月共收集SUI患者14例，年龄38~68岁，病程1~5年，分娩l~4次。BMI20.8~33.9 kg/m²，国际尿失禁咨询委员会尿失禁问卷表简表（ICI-Q-SF）评分7~15分，腹腔漏尿点压（ALPP）3.53~11.86 kPa，最大尿流率（Q_max）24~35 ml/s。应用单切口可调节Ajust^TM吊带系统进行治疗，记录并分析所有患者的临床资料，包括治愈率、满意度和手术并发症等。结果：14例手术均获得成功，手术时间11~36 min，失血量15~45 ml。术中锚栓断裂1例。无膀胱、尿道、肠管、阴道等损伤，无会阴血肿和切口感染，无排尿困难、新发尿急。2例大腿根部疼痛，经相关处理后消失。14例尿失禁均消失，咳嗽试验阴性，随访1~5周无复发。结论：单切口Ajust^TM吊带治疗SUI创伤小，并发症少，近期疗效良好。
- 压力性尿失禁 /
- 单切口 /
- 爱迦吊带 /
- 疗效 /
- 并发症
Abstract: Objective: To evaluate the efficacy and safety of the Ajust^TM system for the treatment of female stress urinary incontinence(SUI).Method: From Sep 2012 to Oct 2012, 14 consecutive subjects were enrolled in the study. The age ranged from 38-68 years, the course of disease ranged from 1-5 years, parity ranged from 1-4 times,BMI ranged from 20.8-33.9 kg/m2,the scores of ICI-Q-SF ranged from 7-15, the ALPP ranged from 3.53-11.86 kPa, and the Q_max ranged from 24-35 ml/s. All patients with primary urodynamic SUI were prospectively selected to receive the adjustable single incision Ajust^TM procedure, the clinical data was recorded and analyzed, included objective and subjective cure rate and operative complications.Result: The operative duration was 11-36 mins, the blood loss ranged from 15-45 ml. During the operation, 1 case of Fixed anchor of Ajust? was broke, there no bladder or urethral injury, no intestinal or vaginal injury, no perineum haematoma or incision infection, no voiding dysfunction or de novo urgency appeared. Only 2 cases of thigh pain occurred, which relieved by corresponding management. According to the definition of cure that deem to the disappear of incontinence and negative cough test, All of the 14 cases SUI were cured.With a follow-up from 1 to 5 weeks, no one recurrence.Conclusion: The adjustable single incision Ajust^TM system was a minimally invasive technique for the treatment of female SUI and with fewer complications, the efficacy of Ajust^TM was good in a short-term follow-up.
- stress urinary incontinence /
- single incision /
- Ajust^TM /
- efficacy /
- complications

HTML全文

参考文献(10)

[1]	KYU S L, MYUNG S C, CHIN K D, et al. The long term (5-years) objective TVT success rate does not depend on predictive factors at multivariate analysis:a multicentre retrospective study[J]. Eur Urol, 2008, 53:176-183.
[2]	LATTHE P M, SINGH P, FOON R, et al. Two routes of transobturator tape procedures in stress urinary incontinence:a meta-analysis with direct and indirect comparison of randomized trials[J]. BJU Int, 2010, 106:68-76.
[3]	任选义,张雪培,魏金星,等. 由内向外经闭孔尿道中段悬吊术治疗女性压力性尿失禁的并发症[J]. 临床泌尿外科杂志, 2011, 26(7):518-520.
[4]	MOLDEN S M, LUCENTE V R. New minimally invasive slings:TVT Secur[J]. Curr Urol Rep, 2008, 9:356-361.
[5]	BACARAT F, IGLESIAS R, PESSOA R, et al. Unfavorable immediate outcome of the TVT secure sling in twenty consecutive women with stress urinary incontinence[abstract 1566] [J]. J Urol, 2008, 179(Supp l):535-536.
[6]	SONG K, PARK J, HAN J Y, et al. The initial experience of TVT-S procedure in female stress urinary incontinence patients[abstract P-36] [J]. Korean J Urol, 2008, 49(Suppl 1):36.
[7]	URWIN G H, HEATON S R. The MiniArc(TM) single-incision sling system for female stress urinary incontinence:early results[J]. Bju Int, 2008, 101:26-26.
[8]	MOORE R D, MITCHELL G K, MIKLOS J R. Single-center retrospective study of the technique, safety, and 12-month efficacy of the MiniArc^TM single-incision sling:a new minimally invasive procedure for treatment of female SUI[J]. Surg Technol Int, 2009, 18:175-181.
[9]	MESCHIA M, BARBACINI P, BACCICHET R, et al. Short-term outcomes with the AjustTM system:a new single incision sling for the treatment of stress urinary incontinence[J]. Int J Urogynaecol, 2011,22:177-182.
[10]	SPINOSA, JEAN P, DUBUIS P, et al. Transobturator surgery for female stress incontinence:a comparative anatomical study of outside-in VS inside-out techniques[J]. BJU Int, 2007, 100(5):1097-1102.