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目的:探讨应用自制吊带系统行经闭孔经阴道无张力尿道中段吊带术(tension-free va-ginal tape-obturator,TVT-O)治疗女性压力性尿失禁的临床价值。方法:采用网状疝气补片自制TVT-O吊带,施行TVT-O手术治疗6例女性压力性尿失禁患者。结果:6例患者均顺利完成手术,术后尿失禁消失5例,咳嗽增加腹压后偶有尿液溢出1例。术后1个月复查尿动力学指标,均无剩余尿;腹腔漏尿点压(abdominal leak point pressures,ALPP)为119(106~142)cmH2O,与术前[32(12~57)cmH2O]比较差异有统计学意义(P<0.05)。所有患者术后随访2~6个月,均无排尿困难,亦无尿失禁。结论:应用自制吊带系统行TVT-O治疗女性压力性尿失禁,操作简便、疗效确切、创伤小、患者恢复快,可供临床酌情选用。
Objective: To investigate the clinical value of self-made sling system in the treatment of stress urinary incontinence in women through tension-free va-ginal tape-obturator (TVT-O). METHODS: Six patients with stress urinary incontinence were treated with TVT-O sling by mesh hernia patch. Results: All the 6 patients completed the operation successfully, 5 cases disappeared after incontinence, and 1 case had occasional urine overflow after cough increased abdominal pressure. The urodynamic parameters were reviewed at 1 month after operation and no residual urine was found. The abdominal leak point pressure (ALPP) was 119 (106 ~ 142) cmH2O, which was significantly lower than that before operation [32 (12 ~ 57) cmH2O] The difference was statistically significant (P <0.05). All patients were followed up for 2 to 6 months, no dysuria, no incontinence. CONCLUSION: TVT-O is a self-made sling system for female stress urinary incontinence. It has the advantages of simple and convenient operation, exact curative effect, small trauma and quick recovery of patients. It can be used clinically for discretion.