Lahodny J, Lahodny B, Birner M, Kaider A
Landesklinikum St. Pölten, Abteilung für Geburtshilfe und Gynäkologie, St. Pölten.
Zentralbl Gynakol. 2006 Jun;128(3):117-22. doi: 10.1055/s-2006-933371.
Description of the fateful change of the differing operation methods for the treatment of female stress incontinence between 1979-2005. For the reason of scientific cognitions and many years of applying experience there are two logical and anatomical well-founded possibilities for the treatment of stress incontinence: 1. Elevation of the bladder neck to it's original position by a shortarm sling plasty. In doing that vaginally the ligg. urethrotendinea and the ligg. pubourethralia posteriora are connected suburethrally by a shortarm sling plasty or a double sling plasty and in this way the bladderneck is elevated to the height of the arcus tendineus fasciae pelvis. So a horizontal bladder base plate able to contract results with a retrovesical angle of about 90 %. The anatomic proof for continence. 2. Producing of the urethrovesical reflex by UST (Urethra Surrounding Tape). A polypropylene mesh with a circumference of 1,5 x 2,6 cm is fixed to the inner surface of the right and left os pubis and paraurethrally right and left too. This stable hammock causes a physiological impression of the dorsal urethra of about 2 mm. Because of that the urethrovesical reflex is set off leading to the contraction of the bladder neck and the relaxation of the detrusor vesicae muscle. This minimal invasive stress incontinence operation method brings about a subjective incontinence healing rate of 83.7 % and a clinical healing rate of 97.7 %. That means the same results like after TVT (Tension Free Vaginal Tape) or TOT (Transobturatorial Tape). In contrast to TVT or TOT there are no complications with UST.
1979年至2005年间女性压力性尿失禁不同手术方法的致命性变化描述。基于科学认知和多年应用经验，治疗压力性尿失禁有两种符合逻辑且有解剖学依据的可能性：1. 通过短臂吊带成形术将膀胱颈提升至其原始位置。经阴道操作，将尿道腱膜和耻骨后尿道韧带在尿道下通过短臂吊带成形术或双吊带成形术连接，从而将膀胱颈提升至盆筋膜腱弓的高度。这样就形成了一个能够收缩的水平膀胱底板，膀胱后角约为90°。这是控尿的解剖学证据。2. 通过尿道周围带（UST）产生尿道膀胱反射。一个周长为1.5×2.6厘米的聚丙烯网片固定在左右耻骨内表面以及尿道旁左右两侧。这个稳定的吊床对尿道背侧产生约2毫米的生理性压迫。由此引发尿道膀胱反射，导致膀胱颈收缩和膀胱逼尿肌松弛。这种微创压力性尿失禁手术方法的主观治愈率为83.7%，临床治愈率为97.7%。这意味着与无张力阴道吊带术（TVT）或经闭孔无张力阴道吊带术（TOT）术后效果相同。与TVT或TOT不同的是，UST没有并发症。
