Spinosa Jean-Pierre, Dubuis Pierre Yves, Riederer Beat
Département de Gynécologie et Obstétrique, Hôpitaux Universitaires de Genève, Suisse.
Prog Urol. 2005 Sep;15(4):700-6.
Transobturator route is now largely used for the positioning of the supporting sub uretral tape in the surgical treatment of female urinary incontinence. This operation can be done using the original technique from the outside to the inside or by inside to outside. Our anatomic study evaluates the specific dangers of each
Our study is based on the dissection of seven fresh bodies, therefore 14 obturator regions. The dissections were done after the positioning of the tape from outside to inside on one side and inside to outside on the other side. We particularly studied the distances separating the tape from the inferior pudendal vascular bundle and the posterior branch of the obturator nerve.
With the inside - outside technique there is a greater proximity between the path of the tape and the studied structures, therefore the risk of damage is greater.
The two techniques are not equivalent. There are less vascular and neurological risk using the original outside to inside technique.
经闭孔途径目前在女性尿失禁手术治疗中大量用于放置耻骨后尿道下吊带。该手术可以采用从外向内的原始技术或从内向外的技术完成。我们的解剖学研究评估了每种技术的特定风险。
我们的研究基于对7具新鲜尸体的解剖，因此有14个闭孔区域。在一侧从外向内放置吊带，另一侧从内向外放置吊带后进行解剖。我们特别研究了吊带与阴部内血管束和闭孔神经后支之间的距离。
采用从内向外技术时，吊带路径与所研究结构之间的距离更近，因此损伤风险更大。
两种技术并不等效。采用原始的从外向内技术时血管和神经风险较小。
