目的 探讨经闭孔由外向内入路尿道中段悬吊术(TOT)治疗女性压力性尿失禁(SUI)的疗效.方法 选取2008年10月-2009年9月女性SUI 患者33例,采用TOT治疗.结果 平均手术时间18 min,平均失血量40 ml.33例SUI患者治愈率为90 9%,改善率为9 1%.术中并发阴道损伤2例,无肠管、膀胱和尿道损伤.术后新发尿急3例,排尿困难和腹股沟痛各1例,均经相关处理后缓解.平均随访18个月,无复发患者.结论 TOT 治疗女性SUI安全有效,并降低了血管和神经损伤的潜在危险.%Objective To observe the therapeutic effects of outside - in transobturator middle urethral tape ( TOT ) without any tension in the treatment of female stress urinary incontinence ( SUI ). Methods Clinical data of 33 cases of female SUI underwent TOT between Oct 2008 and Sep 2009 were enrolled. Results The median operative duration was 18 minutes and average blood loss was 40 ml. The curative rate was 90. 9% and improvement rate was 9. 1% . There were 2 cases of vaginal injury and no injury of bladder, urethra or intestine was observed. Three cases of de novo urgency, one case of voiding dysfunction and one case of groin pain occurred postoperatively and all these cases were relieved by corresponding management. The cases were followed - up for 18 months on average and no relapse was noted. Conclusion TOT technique is both efficacious and safety for the treatment of female SUI and it may reduce the potential risk of vascular and nerve injury as well.
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