Objective To evaluate the complications and long-term efficacy of inside-out transobturator transvaginal tape ( TVT-O) for the treatment of stress urinary incontinence ( SUI) .Methods From January 2008 to December 2013,236 consecutive female patients (mean age 56 ±9 years,range 44-88 years)with the symptom of incontinence when abdominal pressure increasing (such as walking), underwent TVT-O operation.All these patients needed pads and were diagnosed with SUI by cough test and Marshall -bonny test before surgery , with the mean international consultation committee on incontinence questionnaire short form ( ICI-Q-SF) score of 15.6 ±3.9.Two grouping methods were used:the mid-term group including patients whose follow-up time was between 6 months and 3 years, the long-term group including patients whose follow-up time >3 years,the group of patients who underwent TVT-O only and the group of patients who underwent TVT-O plus pelvic floor repair at the same time . Their clinical and follow-up data , intraoperative and postoperative complications , subjective and objective effects were recorded and analyzed.Results Of these 236 patients,there were 1 case of bladder perforation (0.4%) and 1 case of intraoperative sling exposure to vagina ( 0.4%) .Postoperative complications included 36 ( 19.1%) groin/puncture point pain ,18 (9.5%) de novo frequency of micturition ,8 (4.2%) urinary retention /difficulty of urination.All the complications were relieved after symptomatic treatment or surgery except 2 cases of urinary retention/difficulty of urination.Their symptom kept existing after urethral dilatation and sling dissection and long-term intermittent self-catheterization was needed .One hundred and eighty-nine patients completed more than six months of follow-up, with mean follow-up time of ( 35.0 ±12.5 ) months.One hundred and sixteen (61.4%) cases was arranged to mid-term group and 73(38.6%) was arranged to long-term group.88.9%patients ( 168/189 ) were cured objectively and 9.5% patients ( 18/189 ) improved. There was also a significant subjective improvement ( ICI-Q-SF scores:15.6 ±3.9 preoperative versus 6.7 ± 2.3 postoperative,P<0.01).There was no significant difference of both objective and subjective efficacy between mid-term group and long-term group ( cured +improved rate 97.4% versus 95.9%;ICI-Q-SF scores 14.3 ±2.8 versus 16.7 ±3.4 preoperative ,5.8 ±1.2 versus 7.9 ±2.0 postoperative , P>0.05 ) . Patients who underwent TVT-O and those who underwent TVT-O +pelvic floor repair had no significant difference in efficacy (cured +improved rate 97.8%versus 100.0%,P>0.05).Conclusion TVT-O is a safe,effective and durable treatment for SUI , whether or not with concomitant procedure of pelvic floor repairment.

Objective:To analysis clinical curative effect of laparoscopic radical prostatectomy bladder cancer and influence on serum levels of ferritin (SF),soluble interleukin-2 receptor (SIL-2 R) and rumor specific growth factor (TSGF).Methods:98 cases of bladder cancer who were treated in our hospital from August 2012 to February 2016 were selected and randomly divided into the control group 0=49) and the research group (n=49).The patients in the control group were treated with open radical radical cystectomy,while the patients in the research group were treated with laparoscopic radical cystectomy.Then the operation time,intraoperative blood loss,anal exhaust time,hospitalization,the lymph node cleaning,the serum levels of SF,SIL-2R,TSGF,white blood cells and cortisol,the complications and recurrence rate in the two groups were observed and compared.Results:The operation time of research group was longer than that of the control group,while the intraoperative blood loss,the hospitalization and the anal exhaust time were less than those of the control group,and the differences were statistically significant (P＜0.05).There was no statistically significant difference about the numbers of the lymph node and the recurrence rate between two groups (P＜0.05).After treatment,the serum levels of SF,SIL-2R and TSGF in the two groups decreased,while there was no statistically significant difference between the two groups (P＞0.05);After treatment,the white blood cell count and cortisol rise in the two groups increased,while the research group was lower than that of the control group (P＜0.05).Conclusion:LRC and ORC clinical efficacy similar,both of which can reduce the serum levels of SF,SIL-2R and TSGF of patients with laparoscopic radical prostatectomy bladder cancer.