Brophy M M, Klutke J J, Klutke C G
Division of Urology, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
Curr Urol Rep. 2001 Oct;2(5):364-9. doi: 10.1007/s11934-996-0021-1.
In the last century, the pathophysiology of stress urinary incontinence (SUI) has been investigated and several surgical techniques have been utilized for cure. The most recent evolution in the study of SUI is the minimally invasive tension-free vaginal tape (TVT) procedure, which can be done under local anesthesia and intravenous sedation and is individualized for each patient. The procedure recreates the "hammock" of the anterior vaginal wall and endopelvic fascia with a mesh tape of polypropylene. The cure rates of the initial studies are equal to or better than other anti-incontinence procedures, and the permanent supportive mesh is very well tolerated. The TVT creates a backboard on which the urethra compresses itself when it rotates posteriorly during cough or stress. The procedure accomplishes subjective and objective cure without elevating the bladder neck or altering urethral mobility.
在上个世纪，人们对压力性尿失禁（SUI）的病理生理学进行了研究，并采用了多种外科技术进行治疗。SUI研究的最新进展是微创无张力阴道吊带术（TVT），该手术可在局部麻醉和静脉镇静下进行，且针对每位患者进行个体化操作。该手术使用聚丙烯网带重建阴道前壁和盆腔内筋膜的“吊床”。初步研究的治愈率等于或优于其他抗尿失禁手术，并且永久性支撑网带的耐受性非常好。TVT形成了一个背板，当在咳嗽或用力时尿道向后旋转时，尿道会在其上自行压缩。该手术在不抬高膀胱颈或改变尿道活动度的情况下实现了主观和客观上的治愈。
