Comparison of the efficacy of two surgery methods on female stress urinary incontinence with anterior vaginal prolapse
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摘要: 目的：比较经闭孔无张力阴道吊带术（TVT-O）和TVT-O加阴道前壁修补术两种手术方法治疗女性压力性尿失禁（SUI）合并阴道前壁膨出的疗效。方法： 86例SUI合并阴道前壁膨出患者，随机分为TVT-O手术组（40例）和TVT-O加阴道前壁修补手术组（46例）。术后随访时间6~36个月，按照阴道前壁膨出分度分别进行疗效判定。采用PASW 18.0统计软件分析。结果：TVT-O治疗组的SUI治愈率为52.5%，TVT-O加阴道前壁修补组治愈率为93.5%，两种手术方法疗效差异有统计学意义（P<0.05）。合并Ⅰ度阴道前壁膨出者，做或不做阴道前壁修补，疗效差异无统计学意义（P>0.05）；合并Ⅱ~Ⅲ度阴道前壁膨出者，TVT-O加阴道前壁修补组效果显著优于单纯TVT-O治疗组（P<0.05）。结论：对于SUI合并Ⅱ度以上阴道前壁膨出者，单纯TVT-O治疗效果欠佳，应同时行阴道前壁修补术。
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关键词:
- 压力性尿失禁 /
- 阴道前壁膨出 /
- 经闭孔无张力阴道吊带术 /
- 阴道前壁修补术
Abstract: Objective: To comparison the efficacy of tension-free vaginal tape-obturator(TVT-O)and TVT-O with anterior vaginal repair on treating female stress urinary incontinence with anterior vaginal prolapse.Method: Eighty-six patients diagnosed as stress urinary incontinence with anterior vaginal prolapse were randomly divided into two groups.40 cases were treated with TVT-O,and another 46 cases were treated with TVT-O and anterior vaginal repair.Follow-up time after operation ranged from 6 to 36 months,and the curative effects were assessed according to the degree of anterior vaginal prolapse.PASW 18.0 was used for statistical analysis.Result: The cure rate of TVT-O and TVT-O with anterior vaginal repair on SUI was 52.5% and 93.5%,respectively.There was significant difference between the two groups(P<0.05).No significant difference was observed in cases with Ⅰ° anterior vaginal prolapse(P>0.05).While in patients with Ⅱ° to Ⅲ° anterior vaginal prolapse,the efficacy of TVT-O with anterior vaginal repair was significantly superior than simple TVT-O(P<0.05).Conclusion: The therapeutic efficacy of simple TVT-O was below the mark for patients of stress urinary incontinence with Ⅱ° to Ⅲ° anterior vaginal prolapse,and anterior vaginal repair should be done simultaneously. -
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[1] HANNESTAD Y S,RORTVEIT G,SANDVIK H,et al.A community-based epidemiological survey of female urinary incontinence:the Norwegian EPINCONT study.Epidemiology of Incontinence in the County of Nord-Trøndelag[J].J Clin Epidemiol,2000,53:1150-1157.
[2] RORTVEIT G,DALTVEIT A K,HANNESTAD Y S,et al.Urinary incontinence after vaginal delivery or cesarean section[J].N Engl J Med,2003,348:900-907.
[3] 那彦群, 孙光主编. 中国泌尿外科疾病诊断治疗指南(2009版)[M]. 北京:人民卫生出版社,2009:142-165.
[4] 张弋,樊伯珍,夏红,等.TVT-O在女性压力性尿失禁中的运用[J]. 同济大学学报(医学版),2005,26(1):73-74.
[5] 鲁永鲜,张琳,刘静霞,等.经阴道行阴道旁修补术在阴道前壁及膀胱膨出治疗中的应用[J].中华妇产科杂志,2005,40(3):154-158.
[6] 李优兰,钟东彩.改良阴道旁修补术治疗阴道前壁及膀胱膨出21例[J].临床医学,2009,29(5):26-27.
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