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目的 探讨阴道无张力尿道中段悬吊术(TVT)治疗女性压力性尿失禁的临床结局。方法 2001年 1月至 2003年 12月北京协和医院对 60例经尿动力学证实为压力性尿失禁 (其中 4例为混合性尿失禁)同时伴有不同程度盆底器官膨出患者进行了TVT术及相关妇科手术,采用标准化前瞻、开放研究对术前、后进行评估。结果 单行TVT平均手术时间 27 52min,术中出血量平均为 26.12mL,平均住院天数 1 86d。未发生术中严重并发症, 16.7%患者发生尿潴留的近期并发症;患者年龄≥ 50岁组比 <50岁组易发生尿潴留 (P<0 01 ); 2例(3.3% )发生远期并发症;其他妇科手术与TVT术同时进行无术后病率的发生;以患者主观感觉评价,平均随诊12.38个月, 96.7%患者治愈, 3.3%主观改善明显,无一例无效,随访未见患者有复发的征兆。结论 TVT术是治疗女性压力性尿失禁的一种微创、安全和有效的手术方法。其他妇科手术与TVT术同时操作是可行的。
Objective To investigate the clinical outcome of vaginal tension-free urethral suspension (TVT) in the treatment of female stress urinary incontinence. Methods From January 2001 to December 2003, Peking Union Medical College Hospital (Peking Union Medical College Hospital) performed TVT on 60 patients with stress urinary incontinence (including 4 cases of mixed urinary incontinence) with urinary bladder urinary incontinence accompanied with varying degrees of pelvic organ bulging Surgery and related gynecological surgery, the use of standardized prospective, open study of preoperative and postoperative assessment. Results The average operation time of one-line TVT was 27 52min. The average amount of bleeding during operation was 26.12mL and the average length of stay was 1 86 days. There was no serious intraoperative complications and immediate complications of urinary retention occurred in 16.7% of the patients. Urine retention was more likely to occur in patients aged> 50 years and younger than 50 years (P <0.01), and in 2 cases (3.3% Complications; Other gynecological surgery and TVT surgery at the same time without postoperative morbidity; subjective sensory evaluation of patients, the average follow-up of 12.38 months, 96.7% of patients were cured, 3.3% subjective improvement significantly, no one was invalid, no follow-up Patients have a sign of recurrence. Conclusion TVT is a minimally invasive, safe and effective surgical method for the treatment of female stress urinary incontinence. Other gynecological surgery and TVT operation is feasible.