(中文)Randomized Contasure Needleless versus TVT0[1].doc

1、1Int Urogynecol JDOI 10.1007/s00192-011-1380-9原始著作用于治疗压力性尿失禁 Contasure-Needleless与 transobturator-TVT的对比Lluis Amat i Tardiu Eva Martinez Franco Josep Maria Lail la Vicens收于：2010 年 5 月 24 日/接受：2011 年 2 月 4 日Urogynecological 协会 2011摘要介绍 用于治疗压力性尿失禁(SUI)的单切口设备在过去几年就被引进了。我们报道了在 Obturator Tension-free 阴道胶

2、带(TVT-O)和 Contasure-Needleless (C-NDL)间的对比。方法 第一年患有 SUI 的 158 位妇女将按计划接受 TVT-O 或 C-NDL，并做随访。记录了流行病信息、并发症，失血和疼痛程度。我们也分析压力测压和生活质量。结果 跟 54 (90%) 的 TVT-O比较，(87.5%) C-NDL表现出了负压。Sandvik严重指数在 C-NDL组中是 75.4%，而在 TVT O (p500 ml) 1 0与手术无关 (n=55) 0 0与手术有关 (n=103) 1 0手术时膀胱受伤 1 1与手术无关(n=55) 0 0与手术有关(n=103) 1 1泌尿感染

3、 1 0与手术无关(n=55) 0 0与手术有关(n=103) 1 0术后疼痛5 直观类比 1 7 0.023与手术无关(n=55) 1 2 0.551与手术有关 (n=103) 0 5 0.024尿滞留 4 3 1与手术无关(n=55) 1 1 1与手术有关(n=103) 3 2 1导管插入(天) 1.72 1.86 0.491与手术无关(n=55) 0.98 1.14 0.296与手术有关(n=103) 2.18 2.16 0.916医院许可 (天) 2.02 2.39 0.064与手术无关(n=55) 1.04 1.04 0.982与手术有关(n=103) 2.65 2.96 0.098

4、8表 3. 随访 12 个月的并发症C-NDL TVT-Op value重新失禁 7 10 0.298排尿困难 0 1 0.202网格挤出 0 1 0.451尿路感染复发 1 1 19表 4. 12 个月随访结果C-NDL TVT-O 绝对差(IC 95%) p value负压检测 63/72 (87.5%) 54/60 (90%) 2.5(-9.2-13.7) 0.015Sandvik 检测手术前 8/69(11.6%) 5/55(9.1%) 2.5(-9.4-13.7) 0.015非常满意 29/73 (39.7%) 20/60 (33.3%)满意 39/73 (53.4%) 35/60

5、(58.3%)不满意 5/73 (6.8%) 5/60 (8.3%) -1.5 (-12.1-8.1) 0.00110参考文献1.Wahle G, George P, Young H, Raz S (1983) Anatomy and patophisiology of pelvic support. WB Saunders Company, Philadelphia2.Petros PE, Ulmsten UI (1990) An integral theory of female urinary incontinence: experimental and clinical conside

6、rations. Acta Obstet Gynecol Scand Suppl 153:7-313.Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 7:81 -864.Ward K, Milton P, United Kingdom and Ireland Tension-free Vaginal Ta

7、pe Trial Group (2002) Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. Br Med J 41:469-4735.Paraiso MF, Walters MD, Karram MM, Barber MD (2004) Laparoscopic Burch colposuspension versus tension-free vaginal tape:

8、a randomized trial. Obstet Gynecol 104:1249-12586.El-Barky E, El-Shazly A, El-Wahab OA, Kehinde EO, Al-Hunayan A, Al-Awadi KA (2005) Tension free vaginal tape versus Burch colposuspension for treatment of female stress urinary incontinence. Int Urol Nephrol 37:277-2817.Ward KL, Hilton P (2008) On be

9、half of the UK and Ireland TVT trial Group tension-free vaginal tape versus colposuspesion for primary urodynamic stress incontinence: 5-year follow up. BJOG 115:226-2338.Agostini A, Bretelle F, Franchi F et al (2006) Immediate complications of tension-free vaginal tape (TVT): results of a Frech survey. Eur J Obstet Gynecol Reprod Biol 81:72-779.Barry C, Lim YN, Muller R, Hitchins S et al (2007) A multi-centre, randomised clinical control trial comparing the retropubic (RP) approach versus the transobturator approach (TO) for tension-free, suburethral sling treatment of