经闭孔尿道中段无张力悬吊改良术治疗女性压力性尿失禁的疗效

doi:10.19723/j.issn.1671-167X.2026.02.018

摘要/Abstract

摘要：

目的: 评估经闭孔尿道中段无张力悬吊术(tension-free vaginal tape-obturator，TVT-O)的改良术式TVT-Abbrevo(简称TVT-A)治疗女性压力性尿失禁(stress urinary incontinence，SUI)的疗效。方法: 回顾分析2014年4月至2021年12月于北京大学第一医院妇产科因SUI行TVT-A治疗的患者，收集其围术期资料，并在术前及术后随访时对患者进行问卷评分，包括国际压力性尿失禁咨询委员会问卷简表(International Consultation on Incontinence questionnaire-short form，ICI-Q-SF)、盆腔器官脱垂-尿失禁患者性功能问卷简表(pelvic organ prolapse/urinary incontinence sexual questionnaire-12，PISQ-12)、尿失禁生活质量问卷(incontinence quality of life questionnaire，I-QOL)，同时行1小时尿垫试验，分析TVT-A的疗效及其对患者术后生活及性生活质量的影响。结果: 研究期间共130例SUI患者行TVT-A，其中111例患者完成随访。患者中位年龄60(51，66)岁，中位随访时间58.5(15~105)个月。其中10例患者单纯行TVT-A，手术时长为(32.25±8.75) min，出血量为(12.75±8.48) mL。本组111例患者无术中并发症发生，术后并发症中腹股沟区疼痛(8例，7.2%)最常见，其次为新发尿频、尿急(11例，9.9%)和泌尿系感染(4例，3.6%)，无排尿困难、吊带侵蚀、持续性腹股沟区疼痛发生。术后主观治愈106例(95.5%)，主观缓解5例(4.5%)；客观治愈109例(98.2%)，客观缓解2例(1.8%)。手术前后ICI-Q-SF评分分别为16.00(11.00，19.00)分和0.00(0.00，5.00)分，PISQ-12评分分别为(11.49±3.86)分和(13.91±3.96)分，I-QOL总评分(涉及行为限制、心理影响及社会障碍三方面)分别为(84.19±15.36)分和(106.36±8.93)分，术后均较术前明显改善(P＜0.001)。结论: TVT-A术中、术后并发症少，对于女性SUI有良好的治疗效果，且较TVT-O术后腹股沟区疼痛发生率低，可以显著提高患者的生活质量及性生活质量。

关键词: 压力性尿失禁, 女性, 经闭孔尿道中段无张力悬吊改良术, 生活质量

Abstract:

Objective: To evaluate the efficacy of tension-free vaginal tape-Abbrevo (TVT-Abbrevo, TVT-A) in the treatment of female stress urinary incontinence (SUI). Methods: A retrospective analysis was conducted on patients who underwent TVT-A surgery for SUI in the Department of Obstetrics and Gynecology of Peking University First Hospital from April 2014 to December 2021. Perioperative data were collected, and various questionnaire scores were obtained from the patients before and after the operation, including the International Consultation on Incontinence questionnaire-short form (ICI-Q-SF), the pelvic organ prolapse/urinary incontinence sexual questionnaire-12 (PISQ-12), and the incontinence quality of life questionnaire (I-QOL). A 1-hour pad test was also performed. The efficacy of TVT-A and its impact on the patients' postoperative quality of life and sexual life were analyzed. Results: In this comprehensive study, a total of 130 patients with SUI underwent TVT-A, among whom 111 patients completed the follow-up. The median age of the patients was 60 (51, 66) years, and the median follow-up time was 58.5 (15-105) months. Among the 111 patients, for the 10 patients who solely received TVT-A, the operative duration was (32.25±8.75) min, and the blood loss volume was (12.75±8.48) mL. No intraoperative complications occurred in the 111 patients. Among the postoperative complications, groin pain (8 cases, 7.2%) was the most common, followed by new-onset urinary frequency and urgency (11 cases, 9.9%) and urinary tract infection (4 cases, 3.6%). There were no cases of dysuria, sling erosion, or persistent groin pain. Subjectively, 106 cases (95.5%) were cured and 5 cases (4.5%) were relieved; Objectively, 109 cases (98.2%) were cured and 2 cases (1.8%) were relieved. The ICI-Q-SF scores before and after the operation were 16.00 (11.00, 19.00) and 0.00 (0.00, 5.00), respectively; the PISQ-12 scores were (11.49±3.86) and (13.91±3.96), respectively; and the total I-QOL scores (involving behavioral limitations, psychological impact, and social impairment) were (84.19±15.36) and (106.36±8.93), respectively. All scores improved significantly after the operation compared with those before the operation (P < 0.05). Conclusion: TVT-A has fewer intraoperative and postoperative complications, and it has a good therapeutic effect on female SUI. Compared with TVT-obturator, the incidence of groin pain after surgery is lower, which can significantly improve the quality of life and sexual life of the patients.

Key words: Stress urinary incontinence, Female, Tension-free vaginal tape-Abbrevo, Quality of life

中图分类号:

R711.5

郭睿霖, 张蕾, 王宇, 王晓庆, 王潇潇, 年凇汶, 张丽慧, 肖冰冰, 陆叶. 经闭孔尿道中段无张力悬吊改良术治疗女性压力性尿失禁的疗效[J]. 北京大学学报（医学版）, 2026, 58(2): 337-341.

Ruilin GUO, Lei ZHANG, Yu WANG, Xiaoqing WANG, Xiaoxiao WANG, Songwen NIAN, Lihui ZHANG, Bingbing XIAO, Ye LU. Effect of TVT-Abbrevo in the treatment of female stress urinary incontinence[J]. Journal of Peking University (Health Sciences), 2026, 58(2): 337-341.

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参考文献 21

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Degree of urinary incontinence	Before operation	After operation
No	0 (0)	109 (98.2)
Mild	47 (42.3)	1 (0.9)
Moderate	18 (16.2)	1 (0.9)
Severe	22 (19.8)	0 (0)
Extremely severe	24 (21.6)	0 (0)

Questionnaires	Before operation	After operation	t/Z	P
ICI-Q-SF	16.00 (11.00, 19.00)	0.00 (0.00, 5.00)	-9.062	< 0.001
PISQ-12^a	11.49±3.86	13.91±3.96	-6.597	< 0.001
I-QOL
Total	70.67±17.45	95.86±10.15	-14.731	< 0.001
Behavior restriction	28.84±6.38	38.42±3.66	-14.868	< 0.001
Psychological influence	37.72±5.88	43.92±3.24	-11.167	< 0.001
Socialize	17.63±3.96	24.02±2.28	-16.506	< 0.001