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目的总结改良Kelly术治疗女性压力性尿失禁的疗效和价值。方法对28例Ⅱ度以上女性尿失禁患者施行改良的Kelly手术(经阴道前壁尿道下筋膜横形双褥式折叠缝合+阴道前壁修补术),分析其术式改良特点及手术近期疗效。结果改良后术式平均手术时间35 min,术后尿道平均延长1 cm;全部病例术后5 d拔管排尿通畅,尿失禁消失;无阴道感染、出血等并发症发生;随访3个月～3年,27例患者实现尿控,1例合并重度阴道膨出高龄患者6个月后出现Ⅰ度尿失禁。结论改良Kelly术治疗女性压力性尿失禁较经典Kelly手术近期治愈率明显提高,损伤小,并发症少。
Objective To summarize the curative effect and value of modified Kelly operation on female stress urinary incontinence. Methods A total of 28 patients with urinary incontinence of grade Ⅱ or higher underwent modified Kelly surgery (transvaginal anterolateral urethral fascia transverse folding double mattress + vaginal anterior wall repair), and analyzed its surgical modalities and the short-term effect of surgery. Results After operation, the average operation time was 35 min, and the average duration of postoperative urethral extension was 1 cm. In all cases, extubation voided and urinary incontinence disappeared 5 days after operation. Complications such as vaginal infection and bleeding were not observed. All cases were followed up for 3 months to 3 Year, 27 patients achieved urine control, 1 patient with severe vaginal bulging in patients with advanced urinary incontinence after 6 months. Conclusions The Kelly operation is better than the classic Kelly operation in the treatment of female stress urinary incontinence. The cure rate of the Kelly operation is obviously improved with less damage and fewer complications.