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題名 | Quality of Life Impact of Using Tension-free Vaginal Tape for Stress Urinary Incontinence=以無張力陰道吊帶治療婦女應力性尿失禁 |
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作者 | 黃士維; 余宏政; 黃懷恩; 陳淳; Huang, Shi-wei; Yu, Hong-jeng; Wong, Wai-yan; Chen, Jun; |
期刊 | 臺灣泌尿科醫學會雜誌 |
出版日期 | 20021200 |
卷期 | 13:4 2002.12[民91.12] |
頁次 | 頁151-156 |
分類號 | 416.274 |
語文 | eng |
關鍵詞 | 應力性尿性禁; 無張力陰道吊帶; 生活品質; Stress urinary incontinence; Tension-free vaginal tape; Quality of life assessment; |
中文摘要 | 研究目的:評估以無張力陰道吊帶治療婦女應力性尿失禁的有效性,安全性及對生活品質的影響。 材料和方法:前溯性分析由同一位泌尿科醫師從1999年11月至2001年5月,所執行的32例無張力陰道吊帶手術。術前評估包括尿路動力學檢查,一小時的漏尿測試,膀胱尿道排尿攝影及關於下泌尿道症狀和生活品質評估的問卷。術後六個月以尿流速檢查,一小時的漏尿測試和相同的問卷調查來評估術後結果。 結果:病人的平均年齡是58.2歲(從32到78歲),平均生產數為3.6個(從0到7個),平均手術時間是31.2±16.2分鐘(從15到75分鐘)。有兩位病人發生膀胱穿孔併發症,但都順利的以保守療法治療。手術成功率是93%(包括治癒和改善);87%的婦女在導尿管拔除後都可順利小便。病人最大尿流速(術前最大尿流速21.8±6.9 ml/s vs.術後最大尿流速vs.18.6±7.6 ml/s p>0.05)和殘尿比率10.3%±6.7%, p>0.05)沒有顯著改變。生活品質分數則從分4.9±1.6 進步到1.7±1.3分(p<0.01)。除了尿失禁症狀外,頻尿,夜尿和急迫感則有明顯改善。 結論:我們的研究報告顯示,以無張力陰道吊帶治療婦女應力性尿失禁是有效,安全並能改善病患生活品質。但仍需要長的追?以評估長期效果。 |
英文摘要 | OBJECTIVES: To assess the efficacy, safety and quality of life impact of the tension-free vaginal tape (TVT) procedure in the treatment of female stress urinary incontinence. MATERIALS AND METHODS: From November 1999 through May 2001, 32 TVT procedures performed by a single surgeon in the Department of Urology were prospectively analyzed. Preoperative work-up included a questionnaire regarding urinary symptoms and quality of life (QOL) assessment, a 1-hour pad test, voiding cystourethrography (VCUG), and urodynamic studies. The questionnaire, pad test, and uroflowmetry were repeated 6 months after the operation. RESULTS: The mean age of these women was 58.2 (range, 32 to 78) years, and the mean parity was 3.6 (range, 0 to 7); the mean operation time was 31.2 ± 16.2 (range, 15-75) minutes. Bladder perforations occurred in 2 patients and were treated uneventfully with prolonged indwelling catheterization for 7 days; 87% of the women voided satisfactory immediately after catheter removal. The success rate (cure or improvement) was 93%. There was no significant change in urinary flow (maximal flow rate 21.8±6.9 ml/s preoperatively vs. 18.6±7.6 ml/s postoperatively, p > 0.05) or percentage residual urine volume (8.7% ± 5.6% preoperatively vs. 10.3% ± 6.7% postoperatively, p > 0.05). The QOL score improved from 4.9 ± 1.6 to 1.7 ± 1.3 (p < 0.01). In addition to urinary incontinence, urinary frequency, nocturia, and urgency were also significantly improved by the operation. CONCLUSIONS: The TVT procedure is a promising technique that in this short-term analysis, appears to be safe and effective, producing substantial improvement in patients' quality of life. Follow-up studies are warranted to evaluate the long-term outcome of this procedure. |
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