Tsivian Alexander, Neuman Menahem, Yulish Evgeny, Shtricker Avraham, Levin Samuel, Cytron Shmuel, Sidi A Ami
Department of Urologic Surgery, The Edith Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jan;18(1):23-6. doi: 10.1007/s00192-006-0113-y. Epub 2006 Apr 1.
Tension-free transvaginal tape (TVT) placement has recently become the preferred therapeutic approach for female stress urinary incontinence (SUI) in some centers. There are, however, no clearcut guidelines of how to treat patients in whom the procedure has failed. We describe our experience with repeat midurethral synthetic sling (MUS) implantation after a failed similar procedure. Twelve women (mean age 64.3 years) who had undergone a MUS procedure [TVT-9, intravaginal sling (IVS)-2, transobturator tape (TOT)-1] for SUI underwent a repeat MUS (TVT-5, IVS-4, TOT-3) due to persistent or recurrent SUI. The time from the first to the second procedure was 1-48 months. Eleven out of 12 patients (91.7%) achieved full continence (mean follow-up of 23.2 months, range 14-44). We conclude that a repeat MUS for persistent or recurrent SUI is a viable option for patients after an unsuccessful MUS procedure.
在一些中心，无张力经阴道吊带术（TVT）置入术最近已成为治疗女性压力性尿失禁（SUI）的首选治疗方法。然而，对于该手术失败的患者如何进行治疗，目前尚无明确的指导原则。我们描述了在类似手术失败后重复进行尿道中段合成吊带术（MUS）的经验。12名因SUI接受过MUS手术[TVT - 9例、阴道内吊带术（IVS）- 2例、经闭孔吊带术（TOT）- 1例]的女性，由于持续性或复发性SUI而接受了重复MUS手术（TVT - 5例、IVS - 4例、TOT - 3例）。从首次手术到第二次手术的时间为1至48个月。12例患者中有11例（91.7%）实现了完全控尿（平均随访23.2个月，范围14 - 44个月）。我们得出结论，对于MUS手术失败后的患者，重复进行MUS治疗持续性或复发性SUI是一种可行的选择。
