Fitzgerald M P, Mollenhauer J, Brubaker L
Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, Rush-Presbyterian-St.Luke's Medical Center, Chicago, Illinois, USA.
BJU Int. 1999 Nov;84(7):785-8. doi: 10.1046/j.1464-410x.1999.00246.x.
To report our experience of using freeze-dried irradiated fascia lata allografts for suburethral sling procedures.
Between December 1996 and September 1998, 35 patients (mean age 60.25 years, range 37-79) underwent suburethral sling placement with fascia allograft. These patients were reviewed, with the findings at the time of any surgical re-exploration. Eleven (31%) had undergone prior surgery for genuine stress incontinence and 32 (91%) had a preoperative diagnosis of intrinsic sphincter deficiency.
On re-operation for persistent or recurrent stress incontinence, the allograft was present but grossly degenerated in two (6%) patients and completely absent in five (14%) patients. Histology of a retrieved graft fragment showed both fibroblast proliferation and degeneration within the graft.
The use of freeze-dried, irradiated fascia lata for suburethral sling procedures was associated with a material failure rate of >/=20%. We caution against its use in this setting.
报告我们使用冻干辐照阔筋膜同种异体移植物进行尿道下吊带手术的经验。
1996年12月至1998年9月期间，35例患者（平均年龄60.25岁，范围37 - 79岁）接受了阔筋膜同种异体移植物尿道下吊带置入术。对这些患者进行了复查，并记录了任何手术再次探查时的结果。11例（31%）患者曾因真性压力性尿失禁接受过手术，32例（91%）患者术前诊断为固有括约肌缺陷。
在因持续性或复发性压力性尿失禁再次手术时，同种异体移植物存在，但2例（6%）患者的移植物严重退化，5例（14%）患者的移植物完全缺失。取出的移植物碎片组织学检查显示移植物内有成纤维细胞增殖和退化。
使用冻干辐照阔筋膜进行尿道下吊带手术的材料失败率≥20%。我们提醒在此种情况下不要使用。
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