Paick Jae-Seung, Oh Jin Gyu, Shin Jae Wook, Kim Soo Woong, Ku Ja Hyeon
Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Feb;18(2):153-8. doi: 10.1007/s00192-006-0120-z. Epub 2006 Apr 5.
We report the results of the release and tape-shortening techniques in polypropylene pubovaginal slings. Of female patients who had undergone mid-urethral sling procedures [tension-free vaginal tape procedure and suburethral polypropylene (SPARC)], in cases in which postoperative retention occurred, the patients were offered release or tape cutting. Women reporting postoperative urinary incontinence underwent a tape-shortening procedure. In these patients, the tape was shortened by the use of clips. Mean follow-up time after the release and/or the shortening operations was 9.9 months (range 6-18). A total of 15 women, ranging from 41 to 75 years old (mean 58.3) were included in this study. Upon the latest follow-up, six women exhibited prolonged urinary retention and subsequently underwent a release procedure (n=5) or a tape-cutting procedure (n=1). After the release procedure, all patients remained continent, but one patient's urinary retention issues were not resolved, and she subsequently underwent a tape-cutting. Both of the patients who underwent the cutting procedure then developed recurrent stress urinary incontinence. The tape-shortening technique was conducted with nine patients. Seven of these patients recovered their continence, and no one patient experienced any urinary retention or other voiding difficulties. Two patients reported only minimal stress leakage and elected to undergo no further interventions. Our findings suggest that tension plays a substantial role in tension-free mid-urethral sling procedures.
我们报告了聚丙烯耻骨后阴道吊带术的松解和缩短技术的结果。在接受了中段尿道吊带手术（无张力阴道吊带术和尿道下聚丙烯吊带术）的女性患者中，若出现术后尿潴留情况，会为患者提供松解或剪断吊带的处理。报告有术后尿失禁的女性接受了吊带缩短手术。在这些患者中，使用夹子缩短吊带。松解和/或缩短手术后的平均随访时间为9.9个月（范围6 - 18个月）。本研究共纳入15名年龄在41至75岁（平均58.3岁）的女性。在最近一次随访时，6名女性出现持续性尿潴留，随后接受了松解手术（5例）或剪断吊带手术（1例）。松解手术后，所有患者仍保持控尿，但有1例患者的尿潴留问题未得到解决，随后她接受了剪断吊带手术。接受剪断吊带手术的2例患者随后均出现复发性压力性尿失禁。对9例患者实施了吊带缩短技术。其中7例患者恢复了控尿，没有患者出现尿潴留或其他排尿困难。我们的研究结果表明，张力在无张力中段尿道吊带手术中起着重要作用。
