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目的:评价同期手术治疗女性压力性尿失禁(SUI)合并盆腔脏器膨出(POP)的临床疗效。方法:回顾性分析16例同期手术治疗SUI合并POP患者的病例资料,其中9例以SUI为主诉症状,均合并阴道前壁膨出;7例以阴道脱出物为主诉症状,SUI为Ⅱ-Ⅲ型,盆腔脏器脱垂POP-Q﹙盆腔器官脱垂定量分期法﹚分期Ⅱ-Ⅲ期。手术方法为抗尿失禁术,采用TVT-O﹙经闭孔无张力阴道吊带术﹚术、盆底修补术包括阴道前(后)壁修补术、Prolift前片及全片植入。结果:术后随访6～30个月,全部患者临床症状消失,无盆底膨出复发,无尿失禁复发,1例术后出现尿潴留,1例术后3月出现前壁网片侵蚀,经对症处理后均好转。结论:手术同期治疗POP与SUI可以取得满意而稳定的临床疗效,并发症无明显增加,复发率低,但应注意术前严格的尿动力学检测及对患者病情的整体评价,以确定个体化手术方式。
Objective: To evaluate the clinical efficacy of concurrent surgical treatment of female stress urinary incontinence (SUI) combined with pelvic organ prolapse (POP). Methods: A retrospective analysis of 16 cases of concurrent surgical treatment of POP patients with SUI data, including 9 cases of SUI-based symptoms of complaints, were combined with anterior vaginal wall bulging; vaginal discharge in 7 cases as the main complaint symptoms, SUI Ⅱ-Ⅲ Type, pelvic organ prolapse POP-Q (pelvic organ prolapse quantitative staging method) stage Ⅱ-Ⅲ. Surgery for the treatment of incontinence, the use of TVT-O (closed-cell tension-free vaginal tape surgery), pelvic floor repair, including the vaginal anterior (posterior) wall repair, Prolift anterior and total implants. Results: All the patients were followed up for 6 to 30 months. The clinical symptoms of all patients disappeared. No recurrence of pelvic floor bulge and no recurrence of urinary incontinence occurred. One case had postoperative urinary retention and one case had anterior wall mesh erosion after operation. After symptomatic treatment were improved. Conclusions: The surgical treatment of POP and SUI can achieve satisfactory and stable clinical efficacy, no significant increase in complications and low recurrence rate, but should pay attention to preoperative strict urodynamic tests and overall evaluation of the patient’s condition to determine the individual Surgical approach.