关键词: 改良经阴道经闭孔无张力尿道中段吊带术, 无张力经阴道经闭 孔尿道中段吊带术, 女性压力性尿失禁

Abstract: ［Abstract］ Objectives To compare the effectiveness and complications of TVT?A and TVT?O for the treatment of female stress urinary incontinence. Methods From July 2006 to December 2015, 65 patients suffering from FSUI were treated with TVT?O（n=39）or TVT?A（n=26）procedure. The clinical efficacy and operation?correlated complications were observed. Results There were no significant differences in perioperative data including operating time, intraoperative bleeding, days of indwelling catheter, length of stay between the two groups（P>0.05）. Of 65 cases in two groups, 59 cases of urinary incontinence symptoms disappeared completely, 6 cases were improved. Twenty?four cases（92.3%）were cured and 2 cases（7.7%）were improved in TVT?A group. Thirty?five cases（89.7%）were cured and 4 cases（10.3%）were improved in TVT?O group. No significant differences could be found for the curing rates between two groups （P>0.05）. Compared with the TVT?O group, the TVT?A group had lower incidence and more insignificant degree of inner thigh pain at 24 h, l W and 1 month after surgery（P<0.05）. No significant differences were observed for the incidence and degree of inner thigh pain at 3 month, 6 month and 1 year after surgery between TVT?O and TVT?O group（P>0.05）. Two cases in TVT?A group and 4 cases in TVT?O group suffered from postoperative dysuria, and given the indwelling catheter for 3 days. Two cases in TVT?A group and 3 cases in TVT?O group were found urinary frequency, and treated with Tolterodine Tartrate Tablets 2mg twice a day for two weeks. No significant differences were observed for the incidence of postoperative dysuria and urinary frequency between TVT?O and TVT?O group （P>0.05）. No intraoperative complications such as blood vessel, nerve, bladder damage were recorded and no postoperative retropubic hematoma, tape adjustment and other complications occurred in two groups. No recurrence after l year follow?up. Conclusion The study shows that TVT?A procedure is safe and efficacy in treatment of FSUI, but associated with low incidence of recent postoperative inner thigh pain.

Key words: female stress urinary incontinence, modified tension?free vaginal tape?Abbrevo（TVT?A）, tension?free vaginal tape?obturator（TVT?O）