Female Stress Urinary Incontinence Clinical Features And TVT-O Efficacy Evaluation

Purpose1.Discussing on the role of urodynamics, bladder urethra angiograp-hy and international consultation on incontinence questionnaire score tab-le (ICI-Q-SF) in female stress urinary incontinence (SUI) treatment an-d curative effect evaluation.2. Discussing the vesicourethral function and morphological change after treatment of TVT-O.Materials and Methods45female Patients with stress urinary incontinence (SUI) had been collected from2009to2012in XiangYa hospital. Among the45patients,36patients were conducted TVT-O operation, other5patients were not treated with surgery because of detrusor instability. And4patients have severe POP. The data had been collected and analyzed respectively. A detailed record of the name, Medical history, age, Reproductive history, Preoperative symptom degree of the urinary incontinence, Preoperative ICI-Q-SF score, Preoperative Peak flow rate(Qmax), Average urinary flow rate, posvoid residual(PVR), First desire(FD), Maximum cystometr-ic capacity(MCC), Maximum detrusor contraction pressure, abdominal leak Point pressure(ALPP), Maximum urethra-pressure (MUP), Maximu-m urethral closure pressure (MUCP),Static functional length(SFL), the result of cystourethrography, operative times, Postoperative complicati-ons, days of postoperative urinary drainage tube stet, the hospitalization time after operative, the postoperative ICI-Q-SF score, Urodynamic para-meters, cystourethrography, the follow up information and other items.Result1.Operation effectSurgery operative times was25-40min,the mean value was31.2±3.35min. The urinary drainage tube had been removed2～4days after the operation, The patients discharged3～6days after the operation. Two cases generated post operative voiding difficulties. Two patients complained of pain in the bilateral thighs and hips. Urinary urgency happened in two patients. All symptoms abated after symptomatic treatments. There were no patient with urethral and bladder injury、 vaginal wall laceration、heavy bleeding、infectious complications、vaginal or urethral erosion、vaginal fistula after the operation in our group. The incontinence symptoms disappeared in33patients (91.7%) and abated in three patients (8.3%) after the operation.2. Urodynamic parameters and ICI-Q-SF scoreAll patients were successfully followed in our study. ICI-Q-SF, maximum flow rate and average flow rate were significantly lower than those before treatment (P<0.05). In contrast, no statistical differences in PVR, FD, MCC, Pdet.Max, MUP, MUCP and SFL before operation and during follow-up (P>0.05)3. The result of Voiding cystourethrogramThere are28patients conduct Voiding cystourethrogram before operation and after1month later. VCUG conducted before operation showed that the bladder neck and urethra in all cases descended caudally. Contrast medium was observed out of the urethra when the coughed. After operation about1mouth later, the VCUG showed there was not contrast medium leak in all cases and the range of motion of bladder neck and urethra have no change apparently.Conclusionurodynamics, bladder urethra angiography and ICI-Q-SF have very important effect in the treatment and evaluation of SUI. TVT-O has not affection on the storage and micturition function of bladder. At the same time, it will not increase static urethral pressure and extend functional urethral length.