水分离联合TVT术治疗SUI的有效性及安全性分析

Analysis of the Effectiveness and Safety of Hydrodissection Combined with TVT Surgery for the Treatment of SUI

摘要: 目的：比较水分离技术辅助下的耻骨后尿道中段无张力悬吊术(TVT)和经闭孔尿道中段无张力悬吊术(TVT-O)治疗女性压力性尿失禁(SUI)的短期临床结局，探讨水分离技术联合TVT术的安全性和有效性。方法：选取2023年1月至2025年3月在安徽医科大学第四附属医院泌尿外科收治的50例SUI患者，根据手术方法将患者分为水分离组和TVT-O组，其中水分离组采用TVT术，TVT-O组采用TVT-O术，比较两组患者的手术时间、术中出血量、尿管留置时间、住院天数、住院总费用、术后疗效、手术相关并发症等情况。结果：水分离组和TVT-O组的手术时间、术中出血量、尿管留置时间、住院总费用比较均无统计学差异(P > 0.05)，但水分离组的住院天数低于TVT-O组，有统计学差异(P < 0.05)。水分离组的总有效率和TVT-O组的总有效率比较，差异无统计学意义(P > 0.05)。水分离组发生2例手术相关并发症，TVT-O组发生9例，差异有统计学意义(P < 0.05)。结论：水分离技术辅助下的TVT术和TVT-O术治疗SUI的短期疗效相当，但水分离组显示出更低的术后并发症发生风险。

Abstract: Objective: A comparison was made of the short-term clinical outcomes between the retropubic tension-free vaginal tape procedure (TVT) assisted by hydrodissection technology and the tension-free vaginal tape-obturator procedure (TVT-O) for the treatment of female stress urinary incontinence (SUI), aiming to evaluate the safety and efficacy of hydrodissection combined with TVT. Methods: A total of 50 SUI patients admitted to the Department of Urology, the Fourth Affiliated Hospital of Anhui Medical University from January 2023 to March 2025 were selected. The patients were divided into the hydrodissection group and the TVT-O group according to the surgical methods. The hydrodissection group underwent TVT surgery, and the TVT-O group underwent TVT-O surgery. The operation time, intraoperative blood loss, urinary catheter indwelling time, hospital stay, total hospitalization cost, postoperative efficacy, surgery-related complications, etc. of the two groups were compared. Results: There were no statistically significant differences in operation time, intraoperative blood loss, urinary catheter indwelling time, and total hospitalization cost between the hydrodissection group and the TVT-O group (P > 0.05), but the hospital stay in the hydrodissection group was lower than that in the TVT-O group, and the difference was statistically significant (P < 0.05). There was no statistically significant difference in the total effective rate between the hydrodissection group and the TVT-O group (P > 0.05). There were 2 cases of surgery-related complications in the hydrodissection group and 9 cases in the TVT-O group, and the difference was statistically significant (P < 0.05). Conclusion: The short-term therapeutic effects of hydrodissection-assisted TVT and TVT-O in treating SUI were found to be comparable. However, the hydrodissection group demonstrated a lower risk of postoperative complications compared to the TVT-O group.