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目的探讨经阴道无张力尿道中段悬带成形术(intravaginalslingplasty,IVS)及悬吊术(tensionfreevaginaltape,TVT)治疗女性压力性尿失禁手术操作过程中预防膀胱损伤的有效方法。方法回顾性分析从2003年7月至2004年3月期间,应用IVS及TVT手术治疗女性压力性尿失禁过程中采用一系列预防膀胱损伤的方法的效果。结果压力性尿失禁病人共47例,其中行IVS术45例,TVT术2例,全部病人在局麻下完成手术,无一例膀胱损伤。结论IVS及TVT手术过程中穿刺通道的探通、膀胱及膀胱颈的有效移位、紧贴耻骨内侧缘弧形穿刺及遇阻力时适当调整穿刺方向等措施可有效防止膀胱损伤的发生。
Objective To investigate the effective methods of transvaginal tension-free urethral mid-banding (IVS) and tension-free vaginal discharge (TVT) in the treatment of bladder injury during surgical procedure of female stress urinary incontinence. Methods From July 2003 to March 2004, the effects of a series of methods to prevent bladder injury in the treatment of female stress urinary incontinence with IVS and TVT were retrospectively analyzed. Results A total of 47 cases of stress urinary incontinence patients, including 45 cases of IVS surgery, TVT in 2 cases, all patients under local anesthesia to complete surgery, no case of bladder injury. Conclusions Probing into the puncture channel during IVS and TVT operation, effective bladder and bladder neck displacement, arc puncture close to the medial margin of the pubis and proper adjustment of the puncture direction during resistance can effectively prevent the occurrence of bladder injury.