摘要
目的分析经Burch手术治疗压力性尿失禁失败或复发患者的二次手术及治疗结局情况。方法回顾性分析2004年2月至2010年2月于北京协和医院采用Burch手术治疗压力性尿失禁失败或复发患者共5例的临床资料,随访后续手术方式,对其二次手术的长期结局进行分析。根据患者报告的尿失禁主观症状以及患者整体印象改善评分问卷(PGI-I)评价初次Burch手术及二次手术的“主观治愈”,应用1 h尿垫试验结果评价初次Burch手术及二次手术的客观疗效(客观治愈、改善及无效)。结果5例患者中有3例接受经耻骨后无张力尿道中段悬吊带术(TVT)作为二次术式,1例患者接受经闭孔无张力尿道中段悬吊带术(TVT-O),1例患者接受使用Secur悬吊系统的单切口经阴道无张力尿道中段悬吊带术(TVT-Secur)。5例患者由初次Burch手术起随访时间为(14.6±2.4)年(范围:10.8~16.9年),其中3例患者接受TVT二次手术后主观治愈;另2例接受TVT-O或TVT-Secur二次手术的患者则未获长期主观治愈,但TVT-O术后患者客观改善。结论Burch手术后复发的压力性尿失禁患者二次手术行尿道中段悬吊带术是可行的,本研究有限的随访资料提示可考虑使用经耻骨后路径的TVT作为二次手术方式。
Objective To analyze the long-term outcomes of different secondary surgeries in women with recurrent stress urinary incontinence(SUI)after Burch colposuspension.Methods Between February 2004 to February 2010,five women with recurrent SUI after Burch colposuspension in Peking Union Medical College Hospital were retrospectively followed up,and the long-term outcomes of secondary surgeries were analyzed.Subjective cures of Burch colposuspension and secondary surgeries were assessed by patients′self-reported incontinence symptoms and patient global impression of improvement questionnaire;objective cure,improvement or failure were determined by 1-hour pad test.Results Three women underwent tension-free vaginal tape-retropubic(TVT)as the secondary surgery,one underwent tension-free vaginal tape-obturator(TVT-O),and one underwent single-incision tension-free vaginal tape-Secur(TVT-Secur).The follow-up period of five women was(14.6±2.4)years(range:10.8 to 16.9 years).Three women undergoing TVT secondary surgery were subjectively cured;while the other two women undergoing TVT-O or TVT-Secur were not subjectively cured,but the woman undergoing TVT-O was objectively improved.Conclusions It is feasible for women with recurrent SUI after Burch colposuspension to receive the secondary surgery.Our limited data suggests that TVT could be considered.
作者
叶扬
田维杰
王媛
郭建宾
高倩倩
朱兰
Ye Yang;Tian Weijie;Wang Yuan;Guo Jianbin;Gao Qianqian;Zhu Lan(Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,National Clinical Research Center for Obstetric and Gynecologic Diseases,Beijing 100730,China)
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2022年第10期753-757,共5页
Chinese Journal of Obstetrics and Gynecology
基金
国家重点研发计划(2018YFC2002201)
国家自然科学基金(81830043)
中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2020-PT320-003,2021-PT320-001)。
关键词
尿失禁
压力性
尿道下悬吊术
复发
再手术
治疗结果
Urinary incontinence,stress
Suburethral slings
Recurrence
Reoperation
Treatment outcome
