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耻骨阴道直肌筋膜悬吊术后,膀胱收缩强度参数难以预测长期导尿的必要性。

Bladder contraction strength parameters poorly predict the necessity of long-term catheterization after a pubovaginal rectus fascial sling procedure.

作者信息

Groen Jan, Bosch J L H Ruud

机构信息

Department of Urology, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands.

出版信息

J Urol. 2004 Sep;172(3):1006-9. doi: 10.1097/01.ju.0000135339.90689.e8.

Abstract

PURPOSE

We verified if the necessity of long-term catheterization after a pubovaginal rectus fascial sling procedure can be predicted by preoperatively determined bladder contraction strength.

MATERIALS AND METHODS

We analyzed the files of 58 consecutive nonneurogenic women who underwent a sling procedure for severe or refractory stress urinary incontinence. Preoperative urodynamic measurements in these patients were re-analyzed using the power factor WF and the bladder contractility index as bladder contraction strength parameters. Catheterization was considered necessary if the patient self-catheterized at least once daily.

RESULTS

One patient was lost to followup. Three and 6 months after surgery 24 (42%) of 57 and 18 (33%) of 54 patients were on catheterization. On average patients who were not on catheterization had a stronger bladder but the results were not consistently statistically significant.

CONCLUSIONS

A trend toward higher bladder contraction strength in patients not on catheterization was found. However, preoperative urodynamic examination can only poorly predict the necessity of long-term catheterization after sling surgery.

摘要

目的

我们验证了耻骨阴道直肌筋膜悬吊术后长期导尿的必要性是否可通过术前测定的膀胱收缩力来预测。

材料与方法

我们分析了58例因严重或难治性压力性尿失禁接受悬吊手术的非神经源性女性患者的病历。使用功率因子WF和膀胱收缩力指数作为膀胱收缩力参数,对这些患者术前的尿动力学测量结果进行重新分析。如果患者每天至少自行导尿一次,则认为有必要进行导尿。

结果

1例患者失访。术后3个月和6个月时,57例患者中有24例(42%)、54例患者中有18例(33%)仍在进行导尿。平均而言,未进行导尿的患者膀胱收缩力更强,但结果在统计学上并不一致显著。

结论

未进行导尿的患者膀胱收缩力有增强的趋势。然而,术前尿动力学检查对悬吊术后长期导尿必要性的预测能力较差。

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