Giri Subhasis K, Drumm John, Flood Hugh D
Department of Urology, Mid-Western Regional Hospital, University of Limerick, Limerick, Ireland.
J Urol. 2005 Oct;174(4 Pt 1):1306-7. doi: 10.1097/01.ju.0000173926.04596.55.
We report on our technique of endoscopic excision of intravesical tension-free vaginal tape procedure and polypropylene sutures using the holmium laser following various anti-incontinence procedures.
Three patients who previously underwent the tension-free vaginal tape, Burch colposuspension and Stamey vesicopexy, respectively, presented with a range of symptoms including hematuria, recurrent urinary tract infection, frequency, urgency and urinary incontinence. Patients were evaluated with history and examination, and all 3 were found to have nonabsorbable intravesical material.
There was obvious encrustation over the eroded polypropylene material within the bladder. A 365 microm tip firing holmium laser fiber was inserted through the working channel of the flexible cystoscope. The tape and sutures were successfully excised using a holmium laser output of 1.0 J per pulse at a rate of 10 Hz. Mean operative time was 15 minutes.
Holmium laser excision of intravesical polypropylene tape or suture is a minimally invasive solution to the problem of intravesical perforation or erosion following anti-incontinence procedures.
我们报告在各种抗尿失禁手术后，使用钬激光经内镜切除膀胱内无张力阴道吊带手术及聚丙烯缝线的技术。
三名分别先前接受过无张力阴道吊带术、Burch阴道悬吊术和Stamey膀胱固定术的患者，出现了一系列症状，包括血尿、复发性尿路感染、尿频、尿急和尿失禁。通过病史和检查对患者进行评估，发现所有3例患者膀胱内均有不可吸收材料。
膀胱内侵蚀的聚丙烯材料上有明显的结痂。将一根365微米尖端发射的钬激光光纤通过软性膀胱镜的工作通道插入。以10赫兹的频率，每次脉冲1.0焦耳的钬激光输出成功切除吊带和缝线。平均手术时间为15分钟。
钬激光切除膀胱内聚丙烯吊带或缝线是解决抗尿失禁手术后膀胱内穿孔或侵蚀问题的一种微创方法。
