Long Cheng-Yu, Hsu Shih-Cheng, Wu Tung-Pi, Fu Jung-Chung, Hsu Yu-Sin, Su Jiun-Huang
Department of Obstetrics and Gynaecology, Kaohsiung Municipal Hsiao Kang Hospital, Kaohsiung Medical University, Hsiao-Kang District, Kaosiung, Taiwan.
Aust N Z J Obstet Gynaecol. 2003 Feb;43(1):65-9. doi: 10.1046/j.0004-8666.2003.00019.x.
To assess the effect of laparoscopic hysterectomy (LH) on the mobility and position of bladder neck (BN) and urinary symptoms.
We assessed the BN and urinary symptoms of 151 patients by introital ultrasonography and questionnaires before and after LH.
One hundred and fifty-one women who underwent LH from June 1999 to June 2001.
A significant decrease was noted in the number of women exhibiting one or more urinary symptoms from 81 (53.6%) preoperatively to 58 (38.4%) postoperatively (P < 0.01). The incidence of urinary frequency, mild stress incontinence and nocturia decreased significantly after laparoscopic hysterectomy (P < 0.01). Changes in other urinary symptoms following hysterectomy showed no statistical significance (P > 0.05). During straining, the postoperative position of the BN localised more dorsally (P < 0.01) and the ventral mobility of the BN decreased significantly following surgery (P < 0.05). There was no significant difference in the location of the BN with respect to the pubis at rest and during straining, in the cephalocaudal direction, before and after hysterectomy (P > 0.05).
Some patients experienced a substantial improvement of preoperative urinary symptoms following LH, partly as a result of a decrease in the hypermobility of BN.
评估腹腔镜子宫切除术（LH）对膀胱颈（BN）活动度和位置以及泌尿系统症状的影响。
我们通过经阴道超声检查和问卷调查对151例患者在LH术前和术后的BN及泌尿系统症状进行了评估。
1999年6月至2001年6月期间接受LH手术的151名女性。
出现一种或多种泌尿系统症状的女性数量从术前的81例（53.6%）显著降至术后的58例（38.4%）（P<0.01）。腹腔镜子宫切除术后尿频、轻度压力性尿失禁和夜尿症的发生率显著降低（P<0.01）。子宫切除术后其他泌尿系统症状的变化无统计学意义（P>0.05）。在用力时，术后BN的位置更偏向背侧（P<0.01），且术后BN的腹侧活动度显著降低（P<0.05）。子宫切除术前和术后，BN在静息和用力时相对于耻骨在头尾方向的位置无显著差异（P>0.05）。
部分患者在LH术后术前泌尿系统症状有显著改善，部分原因是BN活动过度减少。
