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目的探讨经阴道膀胱颈吊带术治疗女性重度压力性尿失禁的临床效果。方法在膀胱尿道镜观察下,用人造血管作为吊带,Smith针经耻骨上至阴道前壁穿刺悬吊固定,使类圆形尿道内口下壁上抬,使尿道内口呈“⌒”型。治疗的重度女性压力性尿失禁16例。结果本组手术时间30~60min,平均42min。术后第3~5天拔除导尿管,平均4d。术后16例患者尿失禁症状均消失。15例获4个月~6年随访,其中14例参加一般性体力劳动无尿失禁表现,无排尿困难。1例术后4个月平时行走时能控制排尿,但跑跳时仍有尿失禁。结论经阴道膀胱颈吊带术治疗女性重度压力性尿失禁疗效确切,操作简便、经济,并发症少,是一种治疗女性重度压力性尿失禁的有效方法。
Objective To investigate the clinical effect of transvaginal bladder neck sling in treating female severe stress urinary incontinence. Methods Under the observation of bladder urethra, the artificial needle was used as suspenders. The needle of Smith was suspended and fixed on the anterior wall of the vagina through the suprapubic. The inner wall of the circular urethra was lifted upwards so that the inner urethra showed “⌒” type. Treatment of severe female stress urinary incontinence in 16 cases. Results The operation time 30 ~ 60min, an average of 42min. 3 to 5 days after removal of the catheter, an average of 4d. Postoperative urinary incontinence symptoms disappeared in 16 patients. Fifteen patients were followed up for 4 months to 6 years. 14 of them were involved in general incontinence without manual urinary incontinence. 1 case 4 months after operation usually can control urination, urinary incontinence still running. Conclusion Transvaginal bladder neck sling treatment of female patients with severe stress urinary incontinence is effective, easy to operate, economical and has fewer complications. It is an effective method to treat female severe stress incontinence.