经闭孔无张力尿道中段吊带术治疗女性压力性尿失禁的效果及影响术后排尿功能恢复时间的因素分析

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摘要目的探讨由外向内经闭孔无张力尿道中段悬吊术（TOT）对女性压力性尿失禁（SUI）的治疗效果及安全性，并对影响术后排尿功能恢复时间的因素进行分析。方法回顾性选取2015年1月至2021年8月安徽医科大学附属阜阳人民医院收治的114 例SUI 女性患者作为研究对象，根据不同的手术方法分为观察组（63 例）和对照组（51 例）。观察组采用TOT 方法，对照组采用由内向外经闭孔无张力尿道中段悬吊（TVT-O）方法。分析两组患者的手术治疗效果、术中指标情况和术后并发症，并对影响观察组术后排尿功能恢复时间的因素进行分析。结果两组的治疗总有效率比较，差异无统计学意义（P＞0.05）；两组的术中出血量、手术时间和术后住院时间比较，差异无统计学意义（P＞0.05）；观察组的术后并发症总发生率低于对照组，差异有统计学意义（P＜0.05）；年龄、绝经、尿道内括约肌功能缺陷、尿道高活动性、术前残余尿量、最大尿流率均是女性SUI 患者TOT 术后排尿功能恢复时间的独立影响因素（P＜0.05）。结论 TOT 和TVT-O 两种术式治疗SUI 具有同样疗效，但TOT 术式更安全；TOT 术后排尿功能恢复时间受多重因素影响，临床可以采取相应的干预措施，以促进患者更快地恢复正常排尿功能。

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	常雪峰
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关键词 ：经闭孔无张力尿道中段悬吊术, 压力性尿失禁, 疗效, 并发症, 排尿功能恢复时间

Abstract：Objective To investigate the efficacy and safety of the treatment of female stress urinary incontinence (SUI)by external-to-internal trans-obturator tape (TOT), and to analyse the factors affecting the recovery of postoperative voiding function. Methods A total of 114 female patients with SUI treated in Fuyang People′s Hospital Affiliated to Anhui Medical University from January 2015 to August 2021 were retrospectively selected as the research objects. They were divided into the observation group (63 cases) and the control group (51 cases) according to different surgical methods. The observation group was given TOT method, and the control group was given tension-free vaginal tape-obturator technique (TVT-O) method. The patients′ surgical treatment results, intraoperative indexes and postoperative complications were analyzed, and the factors affecting the recovery time of urinary function after surgery in the observation group were analyzed. Results There was no significant difference in the total effective rate between the two groups(P＞0.05). There were no significant differences in the intraoperative bleeding, operation time and postoperative hospital stay between the two groups (P＞0.05). The overall incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P＜0.05). Age, menopause, internal urethral sphincter function defect, high urethral activity,preoperative residual urine volume, and maximum urinary flow rate were all independent influencing factors on the recovery time of voiding function after TOT in female SUI patients (P＜0.05). Conclusion Both TOT and TVT-O have the same efficacy in the treatment of SUI, but TOT is safer. The recovery time of micturition function after TOT is affected by multiple factors. Corresponding clinical intervention measures can be taken to promote patients to recover normal micturition function faster.

Key words： Trans-obturator tape Stress urinary incontinence Efficacy Complications Recovery time of voiding function

通讯作者: 杜永强（1964-），男，安徽阜阳人，主任医师，主要研究方向：泌尿外科。

作者简介: 常雪峰（1995-），男，安徽阜阳人，安徽医科大学阜阳临床学院2020 级外科学（泌尿外科方向）在读硕士研究生，主要研究方向：泌尿外科。

引用本文:

常雪峰；丁利；耿向阳；杨佳佳；王肖；杜永强. 经闭孔无张力尿道中段吊带术治疗女性压力性尿失禁的效果及影响术后排尿功能恢复时间的因素分析[J]. 中国当代医药, 2022, 29(13): 91-95.
CHANG Xuefeng； DING Li ；GENG Xiangyang； YANG Jiajia； WANG Xiao； DU Yongqiang. Analysis of the efficacy of external-to-internal trans-obturator tape in the treatment of stress urinary incontinence in women and the related factors affecting the recovery time of postoperative voiding function. 中国当代医药, 2022, 29(13): 91-95.

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[1]	Wu E，High R，Lewis C，et al.Retropubic mid-urethral slings and de novo urinary urgency and frequency：the role of retropubic hematomas[J].Neurourol Urodyn，2021，40（6）：1686-1694.
[2]	Tammaa A，Aigmüller T，Hanzal E，et al.Retropubic versus transobturator tension-free vaginal tape （TVT vs. TVT-O）：five-year results of the Austrian randomized trial[J].Neurourol Urodyn，2018，37（1）：331-338.
[3]	吕坚伟，刘波，吕婷婷，等.两种尿道中段吊带术治疗女性压力性尿失禁疗效的多中心对比研究[J].中华泌尿外科杂志，2020，41（5）：368-373.
[4]	Palos CC，Maturana AP，Ghersel FR，et al.Prospective and randomized clinical trial comparing transobturator versus retropubic sling in terms of efficacy and safety[J].Int Urogynecol J，2018，29（1）：29-35.
[5]	曾育飞.经闭孔无张力尿道中段悬吊带术治疗女性压力性尿失禁的疗效分析[J].当代医学，2019，25（2）：68-70.
[11]	吴凯，赵立云.改良经闭孔尿道中段悬吊带术治疗女性压力性尿失禁疗效观察[J].新乡医学院学报，2020，37（1）：75-78.
[12]	李文明，姚大强，陈世丰，等.经闭孔尿道中段悬吊治疗女性压力性尿失禁两种术式的解剖学对比[J].第四军医大学学报，2009，19（30）：1964-1966.
[6]	Ahn SH，Park YJ，Kong MK，et al.Impact of age on outcomes of midurethral sling procedures in women[J].Int Urogynecol J，2020，31（4）：785-789.
[7]	Serdinsek T，Martan A，Svabik K，et al.Is the fixation of single incision TVT-S tape as good as that of transobturator tape?An ultrasound study of randomized trial results[J].Int Urogynecol J，2021，32（1）：141-148.
[8]	Abrar S，Razzak L，Mohsin R.The practice of burch colposuspension versus mid urethral slings for the treatment of stress urinary incontinence in developing country[J].Pak J Med Sci，2021，37（5）：1359-1364.
[9]	Zullo MA，Plotti F，Calcagno M，et al.One-year follow-up of tension-free vaginal tape （TVT） and trans-obturator suburethral tape from inside to outside （TVT-O） for surgical treatment of female stress urinary incontinence：a prospective randomised trial[J].Eur Urol，2007，51（5）：1376-1382.
[10]	Pastore AL，Palleschi G，Al Salhi Y，et al.Evaluation of sexual function and quality of life in women treated for stress urinary Incontinence：tension-free transobturator suburethral tape versus single-incision sling[J].J Womens Health（Larchmt），2016，25（4）：355-359.
[13]	王凤玫，宋健，宋岩峰.两种经闭孔无张力尿道悬吊术治疗压力性尿失禁疗效对比研究[J].中国妇产科临床杂志，2009，10（1）：16-18.
[14]	Lazarou G，Minis E，Grigorescu B.Outcomes of stress urinary incontinence in women undergoing TOT versus Burch colposuspension with abdominal sacrocolpopexy[J].Int Urogynecol J，2019，30（2）：245-250.
[15]	Ras L，Roskam SFN，Kruger PF，et al.Retrospective review of intra-and post-operative complications with minimal versus large space of Retzius infiltration at the time of retropubic TVT placement[J].Int Urogynecol J，2019，30（5）：743-751.
[16]	Lucena HM，Rai H，Siozos C，et al.Early postoperative voiding dysfunction after insertion of retropubic midurethral tape[J].Int Urogynecol J，2016，27（10）：1529-1533.
[17]	Lin L，Huang M，Su T，et al.Comparison between tensionfree vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery[J].Taiwan J Obstet Gynecol，2018，57（4）：528-531.
[18]	Ford AA，Ogah JA.Retropubic or transobturator mid-urethral slings for intrinsic sphincter deficiency-related stress urinary incontinence in women：a systematic review and meta-analysis[J].Int Urogynecol J，2016，27（1）：19-28.