Kaum H J, Wolff F
Women's Hospital of the City of Cologne, Germany.
Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):110-5; discussion 115. doi: 10.1007/s001920200025.
All known original and subsequent publications describing the treatment of stress urinary incontinence by means of tension-free vaginal tape (TVT) assert that fixing the tape in a midurethral position is an absolute requirement for restoring continence and avoiding bladder voiding disorders. These studies assume that TVT works by replacing defective pubourethral ligaments inserting at the midurethra. In 20 patients we intraoperatively marked the suburethral position of the tape by metal clips and X-ray-proof string, and documented this postoperatively by X-ray images. In most cases the tape was located in the proximal third of the urethra, which did not cause a higher rate of bladder voiding disorders. All 20 patients became continent through the operation. We do not contest the efficiency of the TVT procedure, but we disprove first, that correctly performed operations always result in the midurethral location of the tape, and secondly that the midurethral position is decisive for its success.
所有已知的描述经阴道无张力尿道中段吊带术（TVT）治疗压力性尿失禁的原始及后续出版物均称，将吊带固定于尿道中段位置是恢复控尿及避免膀胱排尿障碍的绝对必要条件。这些研究认为，TVT的作用机制是替代在尿道中段插入的有缺陷的耻骨尿道韧带。我们在20例患者术中用金属夹和不透X线的线标记吊带在尿道下的位置，并在术后通过X线影像记录。在大多数情况下，吊带位于尿道近端三分之一处，并未导致更高的膀胱排尿障碍发生率。所有20例患者通过手术实现了控尿。我们并不质疑TVT手术的有效性，但我们首先反驳的是，正确实施的手术并不总是导致吊带位于尿道中段位置，其次反驳的是尿道中段位置对其成功起决定性作用。
