Comparison of the Efficacy and Safety Between TVT-O and TVT-O with Biofeedback Pelvic Floor ElectricalStimulation on Female Stress Urinary Incontinence
目的 探讨单纯经闭孔无张力尿道中段悬吊术（TVT-O术）与TVT-O术结合电刺激生物反馈治疗女性压力性尿失禁（SUI）的疗效。方法 将 2012年1月至2013年 12月120例女性中至重度SUI 患者按随机分配表随机分为两组，A组60例单纯采用TVT-O术式，B组60 例采用电刺激生物反馈结合TVT-O术疗法（完成TVT-O手术后3个月,接受电刺激生物反馈疗法2个疗程），对所有患者于TVT-O术后1年门诊随访，观察临床症状改善的情况，主观疗效指标包括患者治疗前后72 h排尿日记（总排尿次数、总排尿量、总漏尿事件次数）尿失禁相关生活质量问卷（I-QOL）、国际尿失禁咨询委员会尿失禁问卷表简表评分（ICI-Q-SF）。疗效客观指标包括尿流动力学检查（最大尿流、残余尿量）、Valsalva漏尿点压(VLPP)和尿垫试验。结果 B组患者治愈率、显效率较A组升高（88.33% vs.75% 和16.67% vs. 10%，P均<0.05），而无效率较A组降低（1.67% vs. 8.33%，P<0.05）。B组患者治疗后在总排尿量、I-QOL、ICI-Q-SF、VLPP和尿垫试验方面均优于A组（P<0.05)。结论 TVT-O术结合电刺激生物反馈治疗中至重度女性压力性尿失禁有协同作用，疗效优于单纯TVT-O术。
英文摘要:
Objective To compare the efficacy and safety between tension-free vaginal tape obturator technique (TVT-O) and TVT-O with biofeedback pelvic floor electrical stimulation on the therapy of female stress urinary incontinence. Methods In this prospective study, 120 female patients of female stress urinary incontinence were enrolled from January 2012 to December 2013. The patients were randomly assigned to two groups，60 in group A received TVT-O alone, while 60 in group B not only received TVT-O but also received biofeedback pelvic floor electrical stimulation. All the patients were followed up for 12 months to assess the efficacy and safety of the two procedures. Subjective indices 〔total volume of urine (TV) ,the total frequency of urination (TOV),the total leakage of urine events (TL), urinary incontinence related quality of life questionnaire (I-QOL),International Advisory Committee on urinary incontinence urinary incontinence questionnaire short form scale (ICI-Q-SF)〕 and objective indices 〔Valsalva leak point pressure (VLPP), maximum flow rate (MFR), residual urine volume (RUV),pad test〕 were analyzed. Results Overall, the cure rate was 75% at 1 year follow-up for group A and 88.33% for group B (P <0.05). The effective rate was 16.67% for group A and 10% for group B (P <0.05). The ineffective rate was 8.33% for group A and 1.67% for group B (P <0.05). TV,I-QOL, ICI-Q-SF, VLPP and pad test in group B were superior to group A （P <0.05）. Conclusion Pelvic floor electrical stimulation biofeedback therapy could improve the curative effects of TVT-O on the treatment of female stress urinary incontinence.
