Female Stress Urinary Incontinence Treated By TVT-0Intraoperative Ultrasound Parameter Analysis

Objective:Along with the continuous renewal of diagnosis and treatment technology development, as well as women with understanding of the disease herself and the requirement of increasing the quality of life, female patients with stress urinary incontinence in clinical work more and more to find. We have to make a systematic system of diagnosis and treatment of more requirements. Now clinically treatment of patients with SUI, mild patients we usually use drug, exercise or the other conservative measures to heal, and for patients with moderately or severe often take surgery to relieve or cure. Surgery, are we on the clinical curative effect in patients with moderately or severe SUI is certain treatment. The emergence of TVT-O(Tension-free vaginal tape-obturator) become a better operation method in our clinical. Compared with the TVT or TOT, which is more reduced the intraoperatie injury of the bladder or other internal organs. But because of no special parameters, the surgical operation on patients were mostly based on the long experience with surgeon, in order to assess and predict postoperative recovery, they use experiments such the cough-leakage as tightness of condole belt placed roughly judgment. Our study is through tension-free vaginal tape-obturator(TVT-O) with SUI patients. And applied three-dimensional ultrasound to the perineum observation of intraoperative real-time image situation such as pelvic of the bladder, urethra, at the same time, analyzed the bladder and urethra ultrasonics parameters before and after TVT-O operation and comparing data to the control group.Methods:This experiment set SUI group of21cases of17cases and control group. SUI group selection in2012.2-2014.2in our hospital because of stress urinary incontinence women with TVT-O, while the control group choose healthy check-up crowd. According to the detail in below into the set of conditions, to strictly selected into the crowd. In age, pregnancy time, production time, body mass index under the condition of no statistical difference in our research. Preoperative evaluation on two groups of staff, for the selected staff general inspection and ultrasonic inspection. Ultrasound using three dimensional ultrasound diagnostic instrument. Patients take lithotomy position, the default bladder capacity is300ml, Let patients at rest and Valsalva analyze inside of the pelvic organs and anatomical structure is with ultrasonic, to conclude we can get the distance of bladder neck mobility, posterior urethra-vesical angle and urethral angle. And patients with SUI group also should take the urodynamics and pressure experiment, etc., TVT-O postoperative repeated measurement above value. Compare two sets of data, the SUI group before and after surgery, preoperative SUI group and the control group, and postoperative SUI group and the control group, respectively, using statistical software for the numerical analysis.Results:The use of statistical software analysis of doppler ultrasound measurement of parameters can be seen. The distance of bladder neck mobility and posterior urethra-vesical angle of TVT-O postoperative are all reduced compared with the preoperative(p<0.001), but no statistical difference compared and ultrasonic parameters in the control group. And urethral angle is just the opposite, compared postoperative and preoperative ultrasound parameters is increased. The parameters of the SUI group and the control group was statistically significant, And the parameters of the SUI group and the control group after surgery is not significant. In the preoperative, SUI group of patients with the distance of bladder neck mobility and posterior urethra-vesical angle compared with the control group were bigger.Conclusions:moderately severe stress urinary incontinence in female patients with TVT-O surgery has a good curative effect in clinic, and the operation is relatively convenient, restore faster, with less complications. Urethral high activity is one of the pathogenesis of female stress urinary incontinence. Ultrasound in the intraoperative parameters about the bladder and urethra and positioning of TVT-O tape play an important role. Ultrasound in the intraoperative parameters which can be taken as reference to the location of the TVT-O tape.