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目的分析可调节单切口尿道中段吊带术治疗女性压力性尿失禁(SUI)的临床疗效及安全性。方法 2012年11月至2014年5月应用可调节单切口吊带治疗女性SUI患者43例,年龄(58.6±10.1)岁。单纯性SUI 33例,合并急迫性尿失禁(UUI)患者10例。所有患者手术前后均填写国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)、尿失禁影响问卷简表(IIQ-7)。合并膀胱过度活动症患者手术前后填写膀胱过度活动症症状评分表(OABSS);仍有性生活患者手术前后填写国际盆底器官脱垂/尿失禁患者性生活质量问卷简表(PISQ-12)。所有患者术后填写患者整体印象改善度问卷(PGI-I)。结果 43例患者手术均顺利,随访7~25个月。手术时间(26.8±6.0)min,估计出血量(21.5±5.1)mL。治愈30例(69.8%),改善12例(27.9%),总有效率97.7%,效果不理想1例(2.3%)。手术前后ICI-Q-SF评分分别为(14.2±3.9)、(1.8±3.0)分;IIQ-7评分分别为(9.6±5.0)、(0.8±1.9)分;合并UUI患者OABSS评分分别为(9.2±2.1)、(3.6±2.9)分;有性生活患者PISQ-12评分分别为(30.3±5.1)、(32.3±4.0)分。以上问卷评分结果手术前后均有统计学差异(P<0.05)。术中均未出现并发症。术后出现一过性尿潴留1例;排尿不畅7例;术后6周内出现疼痛8例。无长期疼痛、盆腔血肿、感染、瘘管等并发症发生。结论可调节单切口尿道中段吊带术操作简单、手术时间短、创伤小、临床疗效显著、并发症少、安全性较高,是治疗女性压力性尿失禁安全、有效的方法。
Objective To analyze the clinical efficacy and safety of adjustable single-incision urethral sling in the treatment of female stress urinary incontinence (SUI). Methods From November 2012 to May 2014, 43 patients with female SUI were treated with adjustable single-incision sling, with a mean age of 58.6 ± 10.1 years. There were 33 cases of simple SUI and 10 cases of UUI. All patients underwent ICI-Q-SF and Urinary Incontinence Impact Questionnaire (IIQ-7) before and after surgery. Before and after surgery, patients with overactive bladder should fill out the OABSS (OABSS), and still have the PISQ-12 questionnaire before and after the operation for patients with active pelvic organ prolapse / urinary incontinence. All patients completed the patient’s overall impression improvement degree questionnaire (PGI-I). Results All the 43 cases were operated smoothly and were followed up for 7-25 months. The operation time (26.8 ± 6.0) min, the estimated bleeding volume (21.5 ± 5.1) mL. 30 cases were cured (69.8%), 12 cases (27.9%) were improved, the total effective rate was 97.7%, the effect was not satisfactory in 1 case (2.3%). The scores of ICI-Q-SF before and after surgery were (14.2 ± 3.9) and (1.8 ± 3.0) respectively; the scores of IIQ-7 were (9.6 ± 5.0) and (0.8 ± 1.9) 9.2 ± 2.1) and (3.6 ± 2.9) points respectively. PISQ-12 scores of patients with sexual life were (30.3 ± 5.1) and (32.3 ± 4.0) points respectively. The above questionnaire score results were statistically significant (P <0.05). No intraoperative complications. Postoperative one case of transient urinary retention in 1 case; poor urination in 7 cases; pain within 6 weeks after surgery in 8 cases. No long-term pain, pelvic hematoma, infection, fistula and other complications. Conclusions Adjustable single-incision urethral mid-length sling operation is simple, the operation time is short, the trauma is small, the clinical curative effect is remarkable, the complication is less and the safety is higher. It is a safe and effective method to treat female stress urinary incontinence.