TVTO治疗女性压力性尿失禁 精选文档.ppt

TVT-O 治疗女性压力性尿失禁 * Trademark GYNECARE TVT* Tension-free Support for Incontinence TVT 尿失 禁无张力支持 ? TVT 的尿道中段悬吊已经成为“金标准” ? Long-term, seven year follow-up data presented at 2019 IUGA reported + ? Cure rate of 81% ? Significantly improved rate of 16% ? Comparable to 5 year data of 85% / 11% respectively ? Very low rates of reported major complications in over 500,000 patients ? Reported bowel injury less than 6 / 100,000 procedures ? Reported major vascular injury less than 9 / 100,000 procedures + Nilsson, et. al, 7 Year Follow-up of the Tension-free Vaginal Tape (TVT) Procedure; International Urogynecology Journal , IUGA Abstract # 116 (89); October, 2019. Complications Statement Complication US Ex-US Total % 血管损伤 7 37 44 0.009 尿道磨损 20 0 20 0.004 肠损伤 16 12 28 0.006 神经损伤 3 1 4 0.0008 血肿 4 16 20 0.004 Most Significant Reported Complications ++ Based on over 500,000 patients treated worldwide ++ As of September 26, 2019, seven deaths are associated with GYNECARE TVT. Six cases were for bowel perforation. Five were associated with undiagnosed bowel perforations at the time of surgery. In the sixth case of bowel perforation, no additional information could be obtained. The seventh case was associated with a woman who had a bleeding disorder who died from uncontrolled postoperative bleeding in the retropubic space. Concept Development of GYNECARE TVT Obturator ? Professor Jean de Leval, Chairman of Urology at the University of Liege, Belgium 为什么经闭孔 ? ? 避开耻骨后空间可能带来的好处 ? 减少膀胱穿孔，尤其对有手术史的病人 ? 避免耻骨后血肿 ? 避免肠穿孔 ? 减少大血管的损伤 ? 悬吊带方向的改变可能带来的好处 ? 减少术后尿潴留的发生率 ? 手术时间更短 Retropubic Slings (“U” shaped) F 1 F 1 F 2 F 2 Obturator Slings (Hammock Shaped) “U” Shape vs. Hammock Shape -Hammock shape of sling may result in less