The Risk Factors Of Early Complications After TVT-O And The Precautionary Measures In Women With Stress Urinary Incontinence

Stress urinary incontinence(SUI)is the most common type of incontinence.It is characterized by involuntary urine flow from the urethra when the abdominal pressure increases.Transobturator vaginal tape inside-out(TVT-O)is the well accepted surgical treatment for moderate and severe SUI.However,there are some early complications.Although these complications are not life-threatening,it has seriously affected the recovery,increased postoperative hospital stay,and aggravated the patient's psychological burden.Then the first part was designed to explore the risk factors affecting early postoperative complications after TVT-O in female with SUI.The second part is to explore the clinical effects of predictive nursing measures.Part 1 The Risk Factors of Early Complications after TVT-OObjectiveTo explore the risk factors of early complications after TVT-O in female with stress urinary incontinence.Methods1.190 patients were absorbed in this study from December 2015 to December2016.All the clinical data of patients were collected through evalution.The early complications after TVT-O(<4 weeks)were also recorded.2.The univariate and logistic regression analysis were used to analyze the risk factors of early postoperative complications.ResultsThere were 35 cases(18.42%)with early complications after TVT-O.There were 7 risk factors in univariate analysis.The logistic regression analysis showed that there were 5 factors with statistical significance,there are indwelling catheter time(OR=2.853),nutritional status(OR=0.926),preoperative maximal urine Flow rate(OR=0.856),history of preoperative urinary tract infection(OR=3.101).ConclusionPatients with lower preoperative urinary flow rate,anxiety,longer duration of urinary incontinence and longer time of indwelling catheter after operation might have a higher risk of early complications after TVT-O.Part 2 The Effect of Predictive Nursing on Early Complications after TVT-OObjectiveBased on the risk factors to formulate the predictive nursing interventions and to observe the effects on early complications after TVT-O,the postoperative hospital stay,anxiety status and quality of life were observed in women with stress urinary incontinence.Methods1.96 female were selected according to the Inclusion criteria.They were divided into control group and intervention group.The control group received the routine urological nursing care,and the intervention group accepted the predictive nursing intervention based on the routine urological nursing care.2.The clinical data were collected through evalution.The postoperative hospital stay and the early complications were recorded.3.SPSS 21.0 statistical software was used.Independent samples t-test and non-parametric Mann-Whitney U test weres used for quantitative data.Chi-squared data was used for the qualitative data.And repeated measures analysis of variance was used to compare the scores in anxiety and quality of life of the two groups.Results1.13 cases had the early postoperative complications in the control group,and 5cases in the intervention group.Chi-square test results showed that there was a statistically significant difference between the two groups(X~2=4.375,P<0.05).2.The postoperative hospital stay of the control group was(1-6)days,and the intervention group was(1-4)days.The non-parametric Mann-Whitney U test of time showed a statistically significant difference(Z=-2.071,P<0.05).3.The ICI-Q-SF scores of the intervention group were significantly lower than those of the control at 2 weeks and 4 weeks after the intervention(t=2.304,P<0.05,t=4.638,P<0.05).In terms of changes in time,the ICI-Q-SF scores of the two groups gradually decreased,and there were significantly time effects,intergroup and interaction effects(all P<0.005).4.There was no difference in anxiety scores between the two groups before the intervention.The anxiety scores of the intervention group were significantly different from the control group at 2 weeks(P>0.05)and 4 weeks(P>0.05)after TVT-O.The repeated measurement analysis of variance showed that the anxiety scores of the two groups of patients decreased,but the difference did not have statistical significance of time effects,between groups,interaction effects(all P>0.05).ConclusionThe predictive nursing interventions can reduce the incidence of early postoperative complications,shorten postoperative hospital stay,and reduce the impact of SUI on daily life.