The factors and treatments of lower urinary tract injury caused by tension-free vaginal tape procedure
10.3760/cma.i.issn.1000-6702.2012.07.014
- VernacularTitle:经阴道无张力尿道吊带术引起下尿路损伤的原因分析及处理
- Author:
Jianwei Lü
;
Jing LENG
;
Wei XUE
;
Lixin ZHOU
;
Juanjie BO
;
Dongming LIU
;
Yiran HUANG
- Publication Type:Journal Article
- Keywords:
Tension-free vaginal tape;
Bladder perforation;
Urethral injury;
Factor,treatment
- From:
Chinese Journal of Urology
2012;33(7):522-524
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the influent factors and managements of lower urinary tract injury caused by tension-free vaginal tape (TVT) procedure. Methods From Mar.2001 to Feb.2011,609stress urinary incontinence (SUI) patients were trested by TVT.Lower urinary tract injury appeared in 39 cases (6.4％),which age from 39 to 78 years (average age 52.7 ± 18.3).The history of disease was 2 to 12 years.Preoperative SUI types were 12 cases of Ⅱ type SUI,22 cases of Ⅱ/Ⅲ type SUI and 5 cases of Ⅲ type SUI.The patients who had low urinary tract injury were retrospective analyzed to figure out the causes and influent factors,and recorded the treatments and follow-ups. Results 39 patients (6.4％) suffered from low urinary tract injury,including 36 oases (5.9％) of bladder perforation and 3 cases of urethral injury.In these 39 patients,34 (87.2％) patients had history of pelvic surgeries,including 18 (52.9％) cases of total hysterectomy,9 (26.5％) cases of cesarean section delivery,4 (11.8％) cases of hysteromyomectomia and 3 (8.8％) cases of ovarian surgery.All of the 36 bladder peeroration patients were re-punctured and the catheter was kept for 4 - 5 d.Three urethral injury patients were re-punctured after the urethral rupture was sutured and the catheter was kept for 2 weeks.All the 39 patients were cured and discharged.No urinary fistula,infection or other postoperative complications occurred. Conclusions The history of pelvic surgery may be an important risk factor of the lower urinary tract injury,which should pay attention.If the bladder perforation occurred,re-puncture should be taken by adjust the direction.If there was a urethral injury,the re-puncture should be taken after the suturing of the urethral rupture.
