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目的观察经阴道无张力尿道悬吊术(tension-free vaginal tape procedure,TVT)对女性压力性尿失禁的临床治疗效果。方法采用TVT术对11例女性单纯性真性压力性尿失禁患者进行矫治。结果 11例均一次治愈,手术时间平均29(23~40)min,术后住院时间2~3 d。术后24 h拔除尿管后均可排尿,1例排尿费力1 d后自行缓解;1例下腹疼痛、腹胀,经对症处理后缓解。术后随访4年,无膀胱损伤、排尿困难、吊带感染、耻骨炎、伤口感染等并发症。术后1年有尿不尽感1例,B超检查无残余尿;术后18个月尿流分叉1例,经尿道扩张1次后缓解;有异物感3例。术后4年最大尿流率平均23.3(16.3~29.8)ml/s,均未再发生尿失禁。结论 TVT术是治疗女性压力性尿失禁的一种简单、安全、有效方法 ,长期疗效有待进一步观察。
Objective To observe the clinical effect of transvaginal tension-free vaginal tape procedure (TVT) on female stress urinary incontinence. Methods TVT was used to treat 11 cases of simple spontaneous stress urinary incontinence. Results All the 11 cases were cured at one time. The average operation time was 29 (23-40) minutes and the postoperative hospital stay was 2 ~ 3 days. 24 h after removal of the catheter can be voided, 1 case of urination laborious self-remission 1 d; 1 case of abdominal pain, abdominal distension, symptomatic relief after symptomatic treatment. After 4 years of follow-up, no bladder injury, dysuria, sling infection, pubis inflammation, wound infection and other complications. One year after operation, there was 1 case of incomplete urination, 1 case of residual urine after B-ultrasound examination, 1 case of urinary bifurcation 18 months after operation and 1 case of transurethral dilatation. There were 3 cases of foreign body sensation. After 4 years, the maximal uroflow rate was 23.3 (16.3 ~ 29.8) ml / s on average, and no incontinence occurred again. Conclusion TVT is a simple, safe and effective method to treat female stress urinary incontinence. Long-term curative effect needs to be further observed.