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目的探讨改良盆底重建术对治疗女性压力性尿失禁的效果。方法选择2014年1月至2015年1月在南京军区总医院接受手术治疗的伴有盆底脱垂的压力性尿失禁女性患者65例为研究对象,对伴有盆底脱垂的压力性尿失禁女性患者实施改良盆底重建术,进行疗效评估和1年的随访,并对结果进行分析。结果所有65例患者均顺利完成手术,手术时间为(82.14±23.65)min,出血量为(57.14±14.22)m L;手术成功率达100%。有63例患者达到远期治愈,总治愈率为96.92%,患者总体满意率为100%。术后随访1年,结果显示患者手术后性生活满意度、生活质量、社交情况、排尿情况、情绪影响等明显得到改善(t值分别为2.160、7.555、10.092、12.067、20.688,均P<0.05);术后Grouts-Blaivas评分,65例患者尿失禁症状明显改善,有2例患者剧烈活动偶有漏尿。术后盆腔器官脱垂评分(POP-Q)分度评价,无脱垂者62例,Ⅰ度脱垂者3例。65例患者术后早期并发症主要有:股部疼痛8例,发生率为12.31%;排尿困难5例,发生率7.69%;排尿姿势改变4例,发生率6.15%。结论改良盆底重建手术能够有效维持腹压增加时的尿道闭合压,避免压力性尿失禁发生,手术具有操作简单、并发症少、安全可靠等优点。
Objective To explore the effect of modified pelvic floor reconstruction on female stress urinary incontinence. Methods From January 2014 to January 2015, 65 female stress urinary incontinence patients with pelvic floor prolapse undergoing surgical treatment in Nanjing Military General Hospital were enrolled in this study. Pressure urine with pelvic floor prolapse Incontinence female patients underwent modified pelvic floor reconstruction, efficacy evaluation and 1-year follow-up, and the results were analyzed. Results All the 65 patients completed the operation successfully. The operation time was (82.14 ± 23.65) min and the bleeding volume was (57.14 ± 14.22) m L. The success rate of operation was 100%. 63 patients achieved long-term cure, the total cure rate was 96.92%, the overall patient satisfaction rate was 100%. Postoperative follow-up of 1 year showed that the postoperative sexual satisfaction, quality of life, social conditions, urination, emotional effects were significantly improved (t = 2.160,7.555,10.092,12.067,20.688, respectively, P <0.05 ). After Grouts-Blaivas score, the symptoms of urinary incontinence in 65 patients were significantly improved. Two patients had occasional leakage of urine due to violent activities. Postoperative pelvic organ prolapse score (POP-Q) index evaluation, no 62 cases of prolapse, Ⅰ degree of prolapse in 3 cases. The early postoperative complications in 65 patients were: 8 cases of femoral pain, the incidence rate was 12.31%; 5 cases of dysuria, the incidence rate of 7.69%; 4 cases of urinary posture change, the incidence rate of 6.15%. Conclusion The modified pelvic floor reconstruction can effectively maintain the urethral closure pressure with increased abdominal pressure and avoid the occurrence of stress urinary incontinence. The operation has the advantages of simple operation, less complications, safety and reliability.