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内镜下完全腹膜外腹股沟疝修补术后的尿潴留

Urinary retention following endoscopic totally extraperitoneal inguinal hernioplasty.

作者信息

Lau H, Patil N G, Yuen W K, Lee F

机构信息

Department of Surgery, University of Hong Kong Medical Centre, Tung Wah Hospital, 12 Po Yan Street, Sheung Wan, Hong Kong SAR.

出版信息

Surg Endosc. 2002 Nov;16(11):1547-50. doi: 10.1007/s00464-001-8292-6. Epub 2002 Jun 4.

Abstract

BACKGROUND

The impact of preperitoneal mesh after endoscopic totally extraperitoneal inguinal hernioplasty (TEP) on voiding function has not been previously examined. The objectives of the present study were to evaluate the incidence of and risk factors for urinary retention following TEP.

METHODS

Three hundred consecutive patients who underwent TEP between June 1999 and September 2001 were recruited. Patient records were reviewed retrospectively to identify those who developed postoperative urinary retention. For each case patient, five age-matched control patients were randomly selected. We then compared the clinical data for the case and control groups. A prospective study of uroflowmetry in patients who underwent bilateral TEP was conducted to evaluate the effect of preperitoneal mesh on voiding function.

RESULTS

The overall incidence of urinary retention following TEP was 4% (n = 12). Patients who developed urinary retention stayed in hospital for a significantly longer period than the control group. No significant association was found between the clinical data and postoperative urinary retention. Bilateral TEPs were not associated with significant deterioration in uroflowmetry.

CONCLUSIONS

Urinary retention is a frequent morbidity after TEP and significantly prolongs the length of hospital stay. Preperitoneal Prolene mesh did not cause outflow obstruction or alter bladder contractility. No specific clinical factors were identified that might predict postoperative urinary retention, which was probably multifactorial in causation in our patient population.

摘要

背景

内镜完全腹膜外腹股沟疝修补术(TEP)后腹膜前补片对排尿功能的影响此前尚未得到研究。本研究的目的是评估TEP术后尿潴留的发生率及危险因素。

方法

选取1999年6月至2001年9月期间连续接受TEP手术的300例患者。回顾性查阅患者记录,以确定发生术后尿潴留的患者。对于每例病例患者,随机选择5例年龄匹配的对照患者。然后比较病例组和对照组的临床资料。对接受双侧TEP手术的患者进行尿流率前瞻性研究,以评估腹膜前补片对排尿功能的影响。

结果

TEP术后尿潴留的总体发生率为4%(n = 12)。发生尿潴留的患者住院时间明显长于对照组。未发现临床资料与术后尿潴留之间存在显著关联。双侧TEP与尿流率显著恶化无关。

结论

尿潴留是TEP术后常见的并发症,显著延长住院时间。腹膜前普理灵补片未导致流出道梗阻或改变膀胱收缩力。未发现可预测术后尿潴留的特定临床因素,在我们的患者群体中,其病因可能是多因素的。

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