Foulot H, Uzan I, Chopin N, Borghese B, Chapron C
Service de gynécologie obstétrique II et Médecine de la Reproduction (Pr Chapron), Unité de Chirurgie Gynécologique, Groupe Hospitalier Universitaire Ouest, Université René Descartes (Paris V), CHU Cochin, Paris, France.
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Aug;18(8):857-61. doi: 10.1007/s00192-006-0244-1. Epub 2006 Nov 21.
The aim of the study was to determine Monarc (American Medical Systems) sling position after surgical treatment of stress urinary incontinence (SUI) through the transobturator approach. A total of 54 consecutive women with SUI were evaluated post-operatively with transvaginal ultrasound. A concomitant hysterectomy was performed in ten cases and a concomitant prolapse surgery in six cases. Ultrasound measurements include urethral length, the distance between the upper edge of the sling and the bladder neck (BN-S) and the BN-S/U ratio. The mean distance between the transobturator tape and the bladder neck was found to be 12.6 +/- 3.2 mm in the group of patients who underwent the transobturator procedure alone, 13 +/- 3.1 mm in the transobturator plus hysterectomy group and 12 +/- 2.8 mm in the transobturator plus prolapse group. The superior tape margin was at the mid-urethra in 81.5% of patients and always at a distance greater than 7 mm from the bladder neck. Eight patients did not have satisfactory results after the surgery. Only in one out of these eight patients was the transobturator sling not found to be at the mid-urethra. The superior tape margin of the Monarc sling remained at the level of mid-urethra in the majority of cases. It was never located too proximally beneath the bladder neck.
本研究的目的是通过经闭孔途径手术治疗压力性尿失禁(SUI)后确定Monarc(美国医疗系统公司)吊带的位置。共有54例连续性SUI女性患者接受了术后经阴道超声评估。其中10例患者同时进行了子宫切除术,6例患者同时进行了盆底脱垂手术。超声测量包括尿道长度、吊带前缘与膀胱颈的距离(BN-S)以及BN-S/U比值。单纯经闭孔手术组患者经闭孔带与膀胱颈之间的平均距离为12.6±3.2mm,经闭孔加子宫切除组为13±3.1mm,经闭孔加盆底脱垂组为12±2.8mm。81.5%的患者吊带前缘位于尿道中部,且始终距离膀胱颈大于7mm。8例患者术后效果不满意。这8例患者中只有1例经闭孔吊带未位于尿道中部。在大多数情况下,Monarc吊带的前缘仍位于尿道中部水平。它从未位于膀胱颈下方过近的位置。