CAJ | 학술논문

目的探讨咳嗽试验在经阴道无张力尿道吊带术(TVT)中的应用价值. 方法 2004年1月至2010年1月确诊为女性压力性尿失禁( SsUI)的患者85例行前瞻性研究,随机分为试验组(41例)与对照组(44例).两组均行TVT手术,试验组根据咳嗽试验调整吊带张力,对照组将吊带无张力地置于尿道中段下方.比较两组患者术后48 h拔除尿管后排尿情况及术后12个月的疗效. 结果咳嗽试验组出现排尿困难9例,其中尿潴留4例；对照组术后无排尿困难者.术后12个月随访,咳嗽试验组治愈率为92.6％( 38/41),对照组为93.1％ (41/44),组间比较差异无统计学意义(P＞0.05). 结论 TVT是治疗女性SUI安全有效的微创术式,但尚无证据支持咳嗽试验有助于降低TVT术后排尿困难发生风险及改善长期疗效.
목적 탐토해수시험재경음도무장력뇨도조대술(TVT)중적응용개치. 방법 2004년1월지2010년1월학진위녀성압력성뇨실금( SsUI)적환자85례행전첨성연구,수궤분위시험조(41례)여대조조(44례).량조균행TVT수술,시험조근거해수시험조정조대장력,대조조장조대무장력지치우뇨도중단하방.비교량조환자술후48 h발제뇨관후배뇨정황급술후12개월적료효. 결과 해수시험조출현배뇨곤난9례,기중뇨저류4례；대조조술후무배뇨곤난자.술후12개월수방,해수시험조치유솔위92.6％( 38/41),대조조위93.1％ (41/44),조간비교차이무통계학의의(P＞0.05). 결론 TVT시치료녀성SUI안전유효적미창술식,단상무증거지지해수시험유조우강저TVT술후배뇨곤난발생풍험급개선장기료효.
Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.