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目的:总结经无张力尿道悬吊术治疗压力性尿失禁的临床疗效。方法:回顾性分析我院5年来压力性尿失禁患者接受无张力吊带手术患者46例(年龄35～72岁,平均53岁),其中女43例,男3例。采用经阴道无张力尿道吊带术(TVT)13例,经阴道-闭孔中段尿道吊带术(TVT-O)25例,经会阴-闭孔男性尿道球部悬吊术3例,耻骨上(Sparc)中段尿道吊带术5例。其中9例局麻下完成,其余在腰麻下完成。结果:5例患者失访,40例随访10～50个月尿失禁治愈32例,改善8例。7例术后出现短暂尿潴留,1例出现顽固性排尿困难,膀胱穿孔1例,余手术前后最大尿流率及残尿量差异无显著性;无尿道腐蚀、吊带感染、术后持续疼痛等并发症发生。结论:无张力尿道中段吊带悬吊术是治疗压力性尿失禁可靠方法,疗效确切,操作简单,男性压力性尿失禁(SUI)近期疗效较佳,但长期疗效尚待进一步观察。
Objective: To summarize the clinical efficacy of tension-free urethral suspension for stress urinary incontinence. Methods: Forty-six patients (aged 35-72 years, average 53 years) undergoing tension-free sling surgery in our hospital for 5 years were retrospectively analyzed. There were 43 females and 3 males. Thirteen patients underwent transvaginal tension-free urethral suture (TVT), 25 patients underwent transvaginal-obturator voiding (TVT-O), 3 patients underwent perineal-obturator urethra ball suspension, ) Urethral sling in 5 cases. Nine of them were completed under local anesthesia and the rest were done under spinal anesthesia. Results: Five patients were lost to follow-up, and 40 patients were followed up for 10 to 50 months. Urinary incontinence was cured in 32 cases and improvement was achieved in 8 cases. 7 cases showed short-term urinary retention, 1 case of intractable dysuria, 1 case of bladder perforation, and no significant difference in maximal urinary flow rate and residual urine before and after surgery. No urethral erosion, sling infection and persistent pain after operation Complications occur. CONCLUSION: Tension-free mid-urethral sling suspension is a reliable method for the treatment of stress urinary incontinence. The curative effect is simple and the operation is simple. The short-term efficacy of male stress urinary incontinence (SUI) is better, but the long-term effect needs further observation.