Speights S E, Moore R D, Miklos J R
3400-C Old Milton Parkway, Alpharetta, GA 30005, USA.
J Am Assoc Gynecol Laparosc. 2000 Nov;7(4):515-8. doi: 10.1016/s1074-3804(05)60365-9.
To estimate the rate of injury to the lower urinary tract during laparoscopic Burch urethropexy and/or paravaginal repair.
Retrospective analysis over 30 consecutive months (Canadian Task Force classification II-2). Setting. Community hospital.
One hundred seventy-one consecutive patients.
Laparoscopic Burch urethropexy and/or paravaginal repair.
All patients had intraoperative transurethral videocystoscopy performed with intravenous injection of indigo carmine dye to assess potential injury to bladder or ureter. Four women (2.3%, CI -0.71-0.03) had injury to the lower urinary tract. All four injuries were cystotomies, two in women with previous open retropubic urethropexy. No ureteral ligation or intravesical placement of suture was diagnosed.
Despite most patients having both Burch urethropexy and paravaginal repair, the lower urinary tract injury rate of 2.3% is much lower than the reported 10% for patients having Burch urethropexy alone performed by laparotomy. Reported benefits of laparoscopy including less blood loss and better visualization may explain this result.
评估腹腔镜下Burch尿道悬吊术和/或阴道旁修补术中下尿路损伤的发生率。
对连续30个月的病例进行回顾性分析（加拿大工作组分类II-2）。地点：社区医院。
171例连续患者。
腹腔镜下Burch尿道悬吊术和/或阴道旁修补术。
所有患者术中均经尿道行膀胱镜检查，并静脉注射靛胭脂染料，以评估膀胱或输尿管的潜在损伤。4名女性（2.3%，可信区间-0.71-0.03）发生下尿路损伤。所有4例损伤均为膀胱切开术，其中2例发生在既往有耻骨后尿道悬吊术的女性患者中。未诊断出输尿管结扎或膀胱内缝线置入。
尽管大多数患者同时接受了Burch尿道悬吊术和阴道旁修补术，但2.3%的下尿路损伤发生率远低于报道的剖腹手术单纯行Burch尿道悬吊术患者的10%。腹腔镜手术的已知益处包括失血少和视野更好，这可能解释了这一结果。
