Study On The Mid-urethral Tension-free Tape For Intrinsic Sphincter Deficiency Stress Urinary Incontience

Objective This study is to discuss the curative effect of intrinsic sphincter deficiency stress urinary incontience by using mid-urethral Tension- free Tape,and then to guide the managementof ntrinsic sphincter deficiency stress urinary incontience.Methods This study summarized 40 cases of patients, form June, 2004 to June, 2006, who admitted in the 2nd hospital of Tianjin medical university for the treatment of simple stress urinary incontinence. All patients are female, the mean age was 55.35±10.31 (range 23-74).The main chief complaint are leakage of urine when coughing, sneezing, laughing, changing body posture and increasing abdomen pressure and so on. None of them had neurogenic history, diabetes mellitus history, urinary infection history, pelvic operation history, urinary abnormity history, specificity infection history. Most of the patients have childbearing history. The patients who accompany detrusor instable's urge and /or mixed urinary incontinence were excludeed.According to Video urodynamics results,intrinsic sphincter deficiency stress urinary incontinence was diagnosed with the standard of by both ALPP<60 cmH₂O and synchronize cystourethrography, which manifest the funnel-shaped openess of bladder neck, then they were divided into ISD group(12\40), include a nullipara, and the control group:NISD (nonintrinsic sphincter deficiency) group (28\40).All of the patients were operated by SPARC. 6-12 months after the surgery all of the patients were evaluated by Grouts-Blaivas scoring.Results1. This study has showed there were no statistical significance between 2 groups in procidentia of cavitas pelvis, age, weight, onset time, vaginal delivery times, volume of residual, maximum bladder capacity, Qmax and detrusor pressure during Qmax.2. No statistically difference was seen between the two groups in postoperative urinary retention, newly present frequency and urgency.3. No statistically difference was observed between the two groups in operationbleeding, duration, recovery period, however, ISD group had a shorter length of stay and urinary canal-taking time than NISD group, while ISD group needed more urethral catheterization, there were a statistical significance between them.4. The recovery rate, improvement rate and failure rate of ISD group was 91.67%,8.33%, 0%, respectively, while in the NISD group was 100%, 0%, 0%, there were no statistical significance between the 2 groups.Conclusion Mid-urethral tension-free sling as a safe, effective, minimallyinvasive surgical procedure for the treatment of female stress urinary incontinence, has the same curative effort to intrinsic sphincter deficiency stress urinary incontinence.