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| 篇名 |
Evaluation of Tension-Free Vaginal Tape (TVT) Procedure: Its Safety and Efficacy in the Treatment of Female Stress Urinary Incontience |
| 作者 |
Hui-Lung Tai, Yu-Jun Chang, Chin-Pao Chang, Meng-Yih Yen, Sheng-Hsien Huang,Herng-Jye Jiang, Chun-Chi Chen, Kuo-Hsuan Huang, Pai-Fu Wang |
| 卷期/出版年月 |
37卷4期 (2004/8) |
| 頁次 |
163-170 |
| 摘要 |
Objectives: To assess the surgical results and the associated complications after the tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence.
Methods: A total of 60 women with different types of stress urinary incontinence
or mixed incontinence with urgency in the absence of pelvic prolapse were treated with TVT procedure between June 1999 and December 2001. Preoperative examinations included multi-channel urodynamics. Surgical procedure was performed according to the technique of Ulmsten et al under local, regional or general anesthesia. The surgical results were assessed objectively by urodynamics and subjectively by a three-degree subjective scale.
Results: The average age was 57.6±10.9 (36-79) years and the mean parity was 4±1.2 (2-8). The mean operative time was 40.8±3.9 (25-55) minutes. All patients
were followed up for at least 2 years after the procedure (mean 42.1±9.9, median
41.7, range 25.7-73.7). Objectively, 90% of the patients were cured of stress incontinence. Subjectively, 85% of patients were completely cured and 15% were
improved. Nine patients (15%) had postoperative urine retention, three of them
finally received section of tape. Bladder penetration occurred in four (6.7%) but there was no subsequent complication after removal of Foley catheter. Tape
erosion from the vaginal wound was found in two patients (3.3%). There were no
cases of tape rejection after TVT procedure. The amount of intra-operative blood
loss was minimal. Totally, 10 patients (16.7%) had postoperative urgency including persistent urgency in six patients (6/23) and de novo urgency in four patients (4/37) at final follow-up. Seven patients (11.7%) felt mild suprapubic discomfort.
Conclusions: Tension-free vaginal tape procedure seems to be an effective method
for treating all types of stress incontinence with results comparable with those
obtained by Burch colposuspension and fascial sling procedure. It can be performed under local, regional or general anesthesia with similar high success rates. However, the procedure also had many postoperative complications and the
patients should be informed accordingly. Only well-trained surgeon and careful
preoperative evaluation can decrease the postoperative complications and achieve
satisfactory surgical results. |
| 關鍵詞 |
stress urinary incontinence, TVT procedure |
| 分類 |
Original Articles |
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