生物电刺激联合子宫托治疗Ⅲ度以上盆腔脏器脱垂合并压力性尿失禁的效果

摘要

目的 探讨生物电刺激联合子宫托治疗Ⅲ度以上盆腔脏器脱垂(POP)合并压力性尿失禁(SUI)的效果.方法 选取2013年1月～2017年1月在江门市人民医院确诊为Ⅲ度以上POP,且经尿动力学检查确诊为SUI的患者50例,按尿失禁严重程度分成轻度15例、中度21例、重度14例三组,均采用盆底生物电刺激联合子宫托治疗,治疗前后均填写国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF),并分析尿动力学的变化.结果 所有患者中,轻、中度患者7例(19.4％)治愈,9例(25.0％)显著改善,5例(13.9％)效果不佳,总有效率为86.1％.轻、中度患者治疗后尿失禁评分及尿动力学各项指标均较治疗前有明显改善(P＜ 0.05),重度患者无治愈及显著改善病例,有效率仅为14.3％.结论 生物电刺激联合子宫托的治疗方法能很好改善重度POP合并SUI的症状,尤其在轻中度尿失禁患者效果显著,对不能手术或不愿接受手术的患者可作为替代治疗方案.尿动力学可准确评估治疗效果.%Objective To explore the effect of bioelectrical stimulation combined with pessary in the treatment of over degree Ⅲ pelvic organ prolapse (POP) with stress urinary incontinence (SUI).Methods Fifty patients of over degree Ⅲ POP with SUI in people's Hospital of Jiangmen from Jan 2013 to Jan 2017 were divided into mild (15 cases),moderate (21 cases) and severe (14 cases) group according to the severity of urinary incontinence,all cases were treated by bioelectrical stimulation combined pessary.The ICI-Q-SF scores and urodynamic indexs were compared after treatment.Results In the mild and moderate groups,7 cases were cured (19.4％),9 cases (25.0％) were significantly improved,5 cases (13.9％) were ineffective,the total effective rate was 86.1％.The ICI-Q-SF scores and urodynamic indexs were obviously improved after treatment (P ＜ 0.05).But there were no cured and significantly improved cases in the severe group,the effective rate was only 14.3％.Conclusion Bioelectrical stimulation combined with pessary can improve the symptoms of over degree Ⅲ POP with SUI,especially in mild and moderate patients.It can be an alternative treatment scheme to the patients who are inoperable or unwilling to accept the surgery.Urodynamics can accurately assess the effect of the treatment.