Latini Jerilyn M, Lux Matthew M, Kreder Karl J
Department of Urology, University of Iowa, Iowa City, Iowa 52242-1089, USA.
J Urol. 2004 Mar;171(3):1180-4. doi: 10.1097/01.ju.0000111807.67599.8d.
Sling cystourethropexy for intrinsic sphincter deficiency has more recently been accepted as effective surgical treatment for all types of stress urinary incontinence. We report our experience using autologous fascia lata for sling cystourethropexy, regarding treatment efficacy, harvest site morbidity and patient satisfaction.
A retrospective data base review identified all women who underwent sling cystourethropexy using autologous fascia lata for stress urinary incontinence. A followup survey study using questionnaires (Black and Urogenic Distress Inventory-6) combined with questions regarding pad use, satisfaction and leg morbidity was done.
A total of 100 women who could be contacted and who had undergone autologous fascia lata sling cystourethropexy performed by a single surgeon between 1993 and 2002 were surveyed. Mean patient followup was 4.4 years (range 0.8 to 9.3). Of the women 85% stated that they were dry or improved and 93% were pain-free at the harvest site by 7 days. There was no harvest site infection and no lower extremity thrombotic complication. Of the patients 83% indicated that the procedure had a positive effect on their life with only 4% stating that it had a negative effect, while 77% were satisfied with the procedure, 82% would recommend the procedure to a friend with incontinence and 83% would undergo the procedure if making the decision again.
Autologous fascia lata sling cystourethropexy is associated with high patient satisfaction and treatment efficacy comparable to that of other sling cystourethropexy materials, as determined by questionnaire. Harvest site morbidity is low. Sling cystourethropexy using autologous fascia lata should be considered as a primary surgical approach in women with stress urinary incontinence.
耻骨后膀胱尿道悬吊术治疗真性压力性尿失禁，近年来已被公认为是一种有效的外科治疗方法。我们报告了使用自体阔筋膜进行耻骨后膀胱尿道悬吊术的经验，内容涉及治疗效果、取材部位的发病率及患者满意度。
通过回顾性数据库检索，确定所有因压力性尿失禁接受自体阔筋膜耻骨后膀胱尿道悬吊术的女性患者。采用问卷调查（Black问卷和泌尿生殖系统困扰量表-6），并结合关于护垫使用情况、满意度及腿部发病率的问题，进行随访研究。
对1993年至2002年间由同一外科医生施行自体阔筋膜耻骨后膀胱尿道悬吊术且能取得联系的100名女性患者进行了调查。患者平均随访时间为4.4年（范围0.8至9.3年）。85%的女性表示已无尿失禁或症状有所改善，93%的女性在取材部位术后7天已无疼痛。未发生取材部位感染及下肢血栓形成并发症。83%的患者表示该手术对其生活有积极影响，仅有4%的患者称有负面影响；77%的患者对手术满意，82%的患者会向有尿失禁问题的朋友推荐该手术，83%的患者表示若再次面临选择仍会接受该手术。
根据问卷调查结果，自体阔筋膜耻骨后膀胱尿道悬吊术患者满意度高，治疗效果与其他耻骨后膀胱尿道悬吊术材料相当。取材部位发病率低。对于压力性尿失禁女性患者，自体阔筋膜耻骨后膀胱尿道悬吊术应被视为一种主要的手术方法。
