Sergent Fabrice, Resch Benoît, Diguet Alain, Verspyck Eric, Marpeau Loïc
Clinique Gynécologique et Obstétricale, CHU Charles Nicolle, Rouen, France.
Prog Urol. 2006 Jun;16(3):361-7.
To evaluate the efficacy and possible short-term and medium-term complications of vaginal prosthetic surgery with transobturator fixation to treat prolapse and stress urinary incontinence (SUI) that are often associated in a single operation.
From February 2002 to August 2004, 45 patients with a mean age of 66 +/- 11 years presenting essentially stage 3 or 4 cystocele associated with SUI (documented for 40 cases and revealed by reduction of the prolapse for the other five) were operated according to the transobturator infracoccygeal sling technique.
With a mean follow-up of 31 +/- 9 months, the success rate of the technique was estimated to be 98% anatomically (only one failure) and 91% in terms of urinary symptoms (73% of patients were cured, 18% were improved and 9% failed). No cases of urinary retention were observed, except for one patient with a secondarily infected pelvic haematoma requiring evacuation and the partial removal of the prosthesis. The mean residual urine on discharge was 83 ml. Two patients developed de novo overactive bladder The prostheses exposure rate was 18%.
Combined treatment of vaginal prolapse and associated urinary incontinence is possible by the use of a single transvaginal prosthesis. The medium-term anatomical results are very good. The results on continence are good and a subsequent specific procedure is always possible in the case of failure or insufficient improvement. The prostheses exposure rate is similar to that observed with synthetic transvaginal prostheses.
评估经闭孔固定的阴道修复手术治疗脱垂和压力性尿失禁（SUI）（这两种情况常需在一次手术中联合治疗）的疗效及可能的短期和中期并发症。
2002年2月至2004年8月，对45例平均年龄66±11岁、主要为3期或4期膀胱膨出合并SUI的患者（40例有记录，另外5例通过脱垂复位发现）采用经闭孔尾骨下吊带技术进行手术。
平均随访31±9个月，该技术的解剖学成功率估计为98%（仅1例失败），尿症状改善成功率为91%（73%的患者治愈，18%改善，9%失败）。除1例继发盆腔血肿感染需引流及部分取出假体的患者外，未观察到尿潴留病例。出院时平均残余尿量为83ml。2例患者出现新发膀胱过度活动症。假体暴露率为18%。
使用单一经阴道假体可联合治疗阴道脱垂及相关尿失禁。中期解剖学结果非常好。控尿效果良好，失败或改善不足时后续总有特定的手术方法可行。假体暴露率与合成经阴道假体观察到的相似。
