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目的 评价手术治疗老年女性压力性尿失禁的疗效。 方法 2003 年7 月至2004 年5月在女性尿失禁特需门诊确诊为压力性尿失禁的老年患者70例,根据患者的情况分别采用经阴道尿道中段悬带成型术、经阴道无张力尿道中段悬吊术、经闭孔无张力尿道中段悬吊术、尿道中段童式前路悬吊术及尿道中段童式前路悬吊+阴道前壁膨出桥式补片修补术治疗。对术中情况进行分析及治疗后的效果进行定期随访。 结果 平均手术时间48 min,平均出血量70 ml,无术中并发症。70例中,60例患者术后去除导尿管后能自行排尿,术后48 h出院;10 例术后出现短暂尿潴留后再留置导尿48 h后排尿正常。出院时,70例中有63例主观完全治愈。67例得到1~6个月的随访,61例主观感觉治愈,3例明显改善。随访最长6个月无复发及并发症。 结论 针对不同条件的压力性尿失禁老年患者选择相应的手术方法治疗安全、有效,但其远期疗效及并发症有待于进一步观察。
Objective To evaluate the efficacy of surgical treatment of stress urinary incontinence in elderly women. Methods From July 2003 to May 2004, 70 elderly patients diagnosed as stress urinary incontinence in the special female urinary incontinence clinic were selected. According to the patients’ condition, the mid-vaginal UTIs Hanging surgery, tension-free closed middle urethral obstruction, the middle of the urethra before the suspension of children and the middle of the anterior urethral suspension + anterior vaginal wall ponticular patch repair. On the situation analysis and treatment of the effect of regular follow-up. Results The average operation time was 48 min, the average amount of bleeding was 70 ml, no intraoperative complications. Among the 70 cases, 60 patients were able to urinate spontaneously after removal of the catheter and were discharged at 48 hours after operation. Ten patients had temporary urinary retention after catheterization for 48 hours, and the urination was normal. At discharge, 63 of 70 patients were completely cured subjectively. 67 cases were followed up for 1 to 6 months, 61 cases subjective feeling cured, 3 cases improved significantly. Follow up up to 6 months without recurrence and complications. Conclusion The elderly patients under stress urinary incontinence under different conditions are safe and effective in choosing the appropriate surgical treatment, but its long-term efficacy and complications need to be further observed.