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目的探讨经阴道无张力吊带术TVT-Secur系统治疗女性压力性尿失禁(SUI)的疗效和可行性。方法女性SUI患者35例,年龄33~69岁,病程1~18年。患者盆腔脏器定量分度(POP-Q)正常,棉签试验显示尿道夹角>60度,临床症状评估均为Ⅱ度;患者术前尿动力检查膀胱顺应性均正常,最大尿道闭合压(MUCP)为25~60cmH2O;腹压漏尿点压(VLPP)>60cmH2O。运用经阴道无张力吊带术TVT-Secur系统治疗。观察客观治愈率、主观治愈率及术后并发症。结果 35例中,行“H”形手术25例,行“U”形手术10例(MUCP<30cmH2O)。手术时间(10.0±3.2)min,术中失血约8ml,无尿道及膀胱损伤。术后随访(8.0±2.8)个月,临床治愈27例,症状明显改善4例,复发4例;对尿失禁症状改善效果满意28例。结论 TVT-Secur术式治疗SUI操作方便,短期疗效好。
Objective To investigate the efficacy and feasibility of transvaginal tension-free TVT-Secur system in the treatment of female stress urinary incontinence (SUI). Methods 35 cases of female SUI patients, aged 33 to 69 years, duration of 1 to 18 years. The pelvic organ quantitative index (POP-Q) was normal. The cotton swab test showed that the included urethra was> 60 degrees and the clinical symptoms were evaluated as grade II. The preoperative urodynamic examination showed that the bladder compliance was normal and the maximum urethral closure pressure (MUCP ) Is 25-60 cmH2O; VLPP> 60 cmH2O. The use of transvaginal tension-free TVT-Secur system treatment. Observed objective cure rate, subjective cure rate and postoperative complications. Results Among the 35 cases, 25 cases underwent “H” shape operation and 10 cases underwent “U” shape operation (MUCP <30 cmH2O). Surgery time (10.0 ± 3.2) min, intraoperative blood loss of about 8ml, no urethral and bladder injury. The patients were followed up (8.0 ± 2.8) months, 27 cases were clinically cured, 4 cases were significantly improved, 4 cases were recurrent, and 28 cases were satisfied with the improvement of urinary incontinence symptoms. Conclusion TVT-Secur surgical treatment of SUI easy to operate, short-term curative effect.