【摘要】 目的:探讨TVT悬吊术治疗有尿道固有括约肌功能缺陷(ISD)的女性压力性尿失禁(SUI)患者的疗效。方法:采用TVT悬吊术治疗女性SUI患者114例,将ISD和无ISD患者的疗效进行比较。结果:114例中获得随访者110例(96.5%):无ISD者92例,治愈81例(88.0%),有效10例(10.9%),完全失败1例(1.1%);有ISD者18例,治愈12例(66.7%),有效3例(16.7%),完全失败3例(16.7%)。术后有7例患者出现明显的排尿困难,其中2例为剩余尿阴性的ISD患者,差异有统计学意义。结论:TVT悬吊术是一种治疗女性SUI患者安全、有效和微创的治疗手段,对有ISD的女性SUI患者同样有效,但疗效不如无ISD的患者;特别是当患者年龄大于65岁、最大尿道关闭压小于0.981 kPa或尿道活动度小时,其治疗效果较差。TVT悬吊术治疗ISD时仍应遵循该术式的常规操作。更多还原

【Abstract】 Objective:To evaluate effects of TVT treatment on the female stress urinary incontinence with intrinsic sphincter incontinence.Methods:TVT procedure was utilized to treat SUI.Preoperative and postoperative outcomes of Pad test and urodynamics were studied.Results:Totally 114 patients underwent TVT procedures from May 2002 through December 2004,4 patients were lost to follow up.In 92 cases without ISD,81 were completely cured,another 10 patients were improved and only 1 patient was regarded as failure.However,in 18 patients with ISD,12 patients were completely cured,3 patients were improved and 3 patients were regarded as failure.7 patients suffered from postoperative voiding difficulty,among them 2 patients were ISD with normal residual urine.Conclusions:TVT is an effective,minimally invasive and safe treatment for most of female stress urinary incontinence patients.For patients with ISD,the outcome is not as satisfying as that of patients without ISD,thus further study is necessary for this type of SUI.更多还原