经闭孔尿失禁手术后发生5例补片侵蚀。
Five cases of tape erosion after transobturator surgery for urinary incontinence.
作者信息
Robert Magali, Murphy Magnus, Birch Colin, Swaby Cheryl, Ross Sue
机构信息
Division of Pelvic Floor Disorders and Reconstructive Surgery, Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Alberta, Canada.
出版信息
Obstet Gynecol. 2006 Feb;107(2 Pt 2):472-4. doi: 10.1097/01.AOG.0000172375.57534.a9.
BACKGROUND
Before introducing the transobturator tape into our practice we undertook 52 transobturator tape procedures. The transobturator tape procedures were undertaken with an "outside-in" approach, using nonwoven polypropylene mesh with average pore size of 50 mum.
CASES
Five cases of vaginal erosions have been identified, 1 complicated by a groin abscess. All cases required further procedures to trim (n = 3), resect (n = 1) or remove (n = 1) the tape. One woman had a tension-free vaginal tape procedure. To date, 3 women remain incontinent.
CONCLUSION
Possible reasons for the complications include 1) surgical inexperience (unlikely, given that we have undertaken more than 2000 tension-free vaginal tape procedures without similar complication rates); 2) inherent susceptibility of the "hammock" position of the transobturator tape; or 3) the nonwoven polypropylene tape with mesh size of 50 microm itself may predispose to erosion or abscess.
背景
在将经闭孔尿道中段无张力吊带术引入我们的临床实践之前，我们进行了52例经闭孔尿道中段无张力吊带术。经闭孔尿道中段无张力吊带术采用“由外向内”的方法进行，使用平均孔径为50微米的非织造聚丙烯网片。
病例
已发现5例阴道糜烂病例，其中1例并发腹股沟脓肿。所有病例均需要进一步手术来修剪（n = 3）、切除（n = 1）或移除（n = 1）吊带。1名女性接受了无张力阴道吊带术。迄今为止，3名女性仍存在尿失禁。
结论
并发症的可能原因包括：1）手术经验不足（鉴于我们已经进行了2000多例无张力阴道吊带术，但未出现类似的并发症发生率，这种可能性不大）；2）经闭孔尿道中段无张力吊带“吊床”位置的内在易感性；或3）网孔尺寸为50微米的非织造聚丙烯吊带本身可能易导致糜烂或脓肿。
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