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考夫曼Ⅲ型尿失禁手术的首次经验(植入覆盖聚氨酯泡沫的硅胶凝胶假体)(作者译)

[First experiences with the incontinence operation Kaufman III (implantation of a silicongel prothesis covered with polyurethanfoam) (author's transl)].

作者信息

Riedel B, Brosig W, Kelâmi A

出版信息

Urologe A. 1975 May;14(3):121-6.

PMID:1098258
Abstract

For operative treatment of urinary incontinence after TUR of the prostate, radical prostatectomy and meningocele operation the silicongel prothesis described by Kaufman was implanted. By compression of the bulbus urethrae a sealing effect was achieved. The pressure of the detrusor opens the urethra enough to enable urination. Seven patients were operated. The results directly after the operations were: three very good, two good and two bad. We achieved very good results by implantation of the prothesis "large" -in the case of the two bad operative results we used the "medium" size prothesis. By filling these protheses with 5 ml liquid they proved to be leaky. One of these was operatively removed and replaced by the size "large". This patient later developed a urethra stricture in the implantation region with overflow bladder after having been continent. By internal urethrotomy this condition was restored; except for minor dripping after miction the patient was continent. The prothesis of a direct postoperative continent patient had to be filled. This led to and infection with the development of fistula. The prothesis had to be removed. A further patient who sat on a hard object developed a lesion of the prothesis with resulting incontinence. At least six months after the operations four patients remained continent and three incontinent.

摘要

对于前列腺经尿道切除术后尿失禁、根治性前列腺切除术及脑膜膨出手术,植入了考夫曼描述的硅胶假体。通过压迫尿道球部实现了密封效果。逼尿肌压力使尿道充分开放以排尿。7例患者接受了手术。术后直接结果为:3例非常好,2例良好,2例差。通过植入“大号”假体我们取得了非常好的效果——在2例手术效果差的病例中我们使用了“中号”假体。向这些假体注入5毫升液体后,发现它们有渗漏。其中1个被手术取出并更换为“大号”。该患者在恢复控尿后,植入区域出现尿道狭窄并伴有膀胱充盈性尿失禁。通过尿道内切开术恢复了这种情况;除排尿后轻微滴沥外,患者实现了控尿。一名术后直接控尿的患者的假体需要填充。这导致了感染并形成瘘管。假体不得不被取出。另一名患者坐在硬物上导致假体受损,继而出现尿失禁。术后至少6个月,4例患者保持控尿,3例失禁。

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