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Objective To investigate the efficacy and complication of Tension-free Vaginal Tape (TVT)-Exact for the treatment of type-Ⅲ female stress urinary incontinence (SUI).Methods A total of 20 type-Ⅲ SUI patients enrolled from November 2013 to June 2016 were retrospectively analyzed.The efficacy and complication of the surgery were evaluated.Results The mean operation time was (20.7 ± 1.60)min (range,19-25 min).The blood loss was 20-50 ml.There were no intraoperative bladder or urethral injury,and no vessel or nerve damage.2 cases with mixed SUI were relieved by medicine.No case had urethral or vaginal erosion.Therapeutic efficacy:15 cases were cured (75％),5 cases were improved (25％),and no case was ineffective.Conclusions TVT-E is a simple,min-invasive,safe and effective surgery for type-Ⅲ SUI.While the long-term efficacy needs great amount of clinical data and long-term follow-up to prove.
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Objective To investigate the effects of human umbilical mesenchymal stem cells (hUCMSCs) on Wistar rat models of stress urinary incontinence and its possible mechanism.Methods hUCMSCs cells were separated and extracted from human umbilical cord of cesarean delivery of full-term pregnancy women.The models of stress urinary incontinence (SUI) of Wistar rats were established by imitating delivery damage and ovary removing surgery,and then randomly divided into three groups:model group,transforming growth factor-β1 (TGF-β31) group,hUCMSCs group,and normal rats as normal group;and every group included ten rats.Maximal bladder capacity (MBC),leak point pressure (LPP),abdominal leak point pressure (ALPP),and sneezing experiment of rats including normal rats,model rats and model rats accepted TGF-β1 or hUCMSCs treatment were examined.When the treatment accomplished,the rats were killed and urethral sphincter were separated and examined by hematoxylin eosin (HE) staining and the proteins of troponin Ⅰ (TnI),troponin C (TnC),troponin T (TnT),tropomyosin (Tm),actin (AT),myosin heavy chain (MHC) and myosin light chain (MLC) of urethral sphincter was detected with Western blot method.Results The cells of hUCMSCs were extracted and authenticated,SUI models of Wistar rats were successfully established and authenticated.Compared to model group and TGF-β1 group,the MBC,LPP and ALPP of hUCMSCs group dramatically improved (P ＜ 0.05),while the positive rate of sneezing experiment significantly dropped (P ＜ 0.05).HE staining showed urethral sphincter became attenuation,fracture,sparse and disorder,simultaneously the proteins of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter reduced (P ＜ 0.05).While the damaged urethral sphincter basically restored the normal structure and the proteins of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter up-regulated through hUCMSCs treatment (P ＜ 0.05).Conclusions The treatment of hUCMSCs translation could observably improve the clinic symptoms of SUI Wistar rat models,and its mechanism may be related to enhancement of the protein expression of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter,and were involved in the rehabilitation and reconstruction of urethral sphincter.
ABSTRACT
ObjectiveTo evaluate the curative effect difference between Tong's anterior mesh suspension and modified tension-free vaginal tape-obturator (TVT-O). Methods75 SUI cases were random divided into two groups: Group A (35 cases) were accepted Tong's anterior mesh suspension and group B (40cases) were accepted modified tension-free vaginal tape- obturator. Curative effects, operation safety,and complications and so on, were recorded and compared. ResultsThere had no statistical differences between these two groups on operation time, bleeding lose, operation injury, immediate postoperative urinary retention andcure rates, but the operation expense of group A was cheaper than group B [ (980. 74 ±212.45)yuan vs (2879.06 ±467. 13)yuan , P ＜0.05). ConclusionThe curative effect between two methods were similar. It's a little complicated and fit to be popularized in large hospital to modified tensionfree vaginal tape-obturator. Tong's anterior mesh suspension was performed under completely direct vision,not through pelvic cavity, and it was an economic, convenient and easy way, which not only fit to be popularized in basic hospital, but also a surgical remedial measure to the failures who accepted these operations,such as TVT, SPARC, IVS, MONARC, TOT, TVT-O, etc.