Clinical Analysis Of 53 Cases Of Female Stress Urinary Incontinence Treated By TVT-O

Objective:Follow up and observe the patients who underwent transob-turator vaginal tape inside-out(TVT-O)due to stress urinary incontinence(SUI),and analyze the clinical efficacy,safety and operative points of TVT-O in the treatment of female SUI.Methods:Retrospective analysis was performed on the clinical data of patients with severe female SUI or mild and moderate female SUI who received TVT-O treatment in Hebei General Hospital from January 2015 to December 2016 due to unsatisfactory conservative treatment effect.By consulting the patient's inpatient medical records,the general information of the patient,the intraoperative conditions,postoperative complications,symptoms of SUI and the questionnaire about the impact on the quality of life were recorded through outpatient service and telephone follow-up.The above data were sorted out and analyzed.Results:1.General information of the patients:The average age of the patients was 52.83±8.41 years old,the average body mass index(BMI)was 25.97±2.70kg/m~2,the average course of disease was 36.00(12.00,120.00)months,and the average follow-up time was 34.11±6.39 months.2.Operative conditions:Bleeding volume during operation:The average bleeding volume during operation of all patients was 20.00(5.00,50.00)ml,while the 18 patients receiving TVT-O alone was 6.61±7.34ml.The bleeding volume during operation was significantly increased with other operations,and the difference was statistically significant(P<0.001).Operation time:The average operation time of the 53 patients was 60.50±39.85min,and of the 18patients who underwent TVT-O surgery alone was 22.22±10.80min.The operation time was significantly prolonged by the combination of other surgeries,and the difference between statistically significant(P<0.001).The average postoperative hospitalization days of the patients were 6.00(6.00,6.00)days,while those receiving TVT-O alone were 5.00(4.00,6.00)days.The postoperative hospitalization time of the patients with other surgeries was prolonged,and the difference was statistically significant(P<0.001).3.Questionnaire conditions:International consultation on incontinence questionnaire short form(ICIQ-SF)and incontinence quality of life questionnaires(I-QOL)were used for preoperative and postoperative urinary incontinence and quality of life.ICIQ-SF and I-QOL scores were used for comparison.Both the total score and the sub-score of each part showed that the symptoms of SUI and its influence on life after surgery were significantly improved,with statistically significant differences(P<0.001).The effect of TVT-O treatment was not related to the menopause,and the difference was not statistically significant(P>0.05).4.Complications:All patients successfully completed the surgery,and there were no intraoperative bladder,urethra,obturator nerve and vascular injuries.Postoperative medial thigh pain in 2 patients,were relieved at 3months of follow-up,1 patient had mild dysuria,which was relieved at 6months'follow-up.The vaginal discharge of 1 patient after discharge was bloody,outpatient reexamination was conducted 1 month after surgery,founding the stitching head that has not absorbed completely then removed it,and the symptoms disappeared 3 months after the operation.Vaginal discharge increased in 1 case and vaginitis in 2 cases,which were relieved after treatment.There were 0 cases of mesh exposure or erosion.5.Surgical results:Patients'surgical effects were assessed by the chinese-validated incontinence impact questionnaire(IIQ-7).Subjective cure was achieved in 48 patients,improvement was achieved in 2 patients,recurrence was observed in 1 patient 6 months after surgery,and symptoms were not alleviated in 2 patients after surgery.At the last follow-up,the subjective cure rate of 53 patients was:cured:90.57%,improved:3.77%,invalid:5.66%.Conclusions:1.TVT-O surgery is short in time,less intraoperative bleeding,less difficult and less risky.It can significantly reduce the amount and frequency of urine leakage,improve the quality of life and improve the prognosis of patients,and is an effective surgical approach to treat SUI.2.With fewer complications,TVT-O can be clinically reduced through adequate perioperative preparation and improvement of surgical skills,which is a safe surgical approach to treat female SUI.3.Before and after surgery,ICIQ-SF,IQOL and IIQ-7 scales were used to evaluate the quality of life of patients,which was simple and easy to operate,and suitable for the evaluation and follow-up of TVT-O surgery effect.