Yokoyama Osamu, Tanase Kazuya, Takahara Noriko
Department of Urology, Faculty of Medical Science, University of Fukui.
Hinyokika Kiyo. 2007 Jun;53(6):421-4.
This chapter critically reviews the literature on surgery for stress urinary incontinence (SUI) and pelvic organ prolapse (POP), and medical treatment for overactive bladder in women. The midurethral polypropylene sling was reported to provide a durable option with significant improvement. The tension-free vaginal tape (TVT) procedure is based on a theory of pathophysiology of stress incontinence presented by Petros and Ulmsten. In their "integral theory" impairment of the pubourethral ligament is one of the primary cause of SUI. The transobturator sling was found to be effective in SUI patients with less incidence of perioperative complications and voiding difficulties. Prolapse of the uterus/vaginal apex and posterior vaginal wall may also be found in women with stress incontinence. There are many procedures for the correction of POP. Transvaginal repair of anterior and posterior compartment prolapse with polypropylene mesh has been developed in recent years. It is necessary to assess and compare the current quality of outcomes.
本章对压力性尿失禁(SUI)和盆腔器官脱垂(POP)的外科手术以及女性膀胱过度活动症的医学治疗相关文献进行了批判性综述。据报道,经尿道中段聚丙烯吊带术是一种持久有效的选择,能带来显著改善。无张力阴道吊带术(TVT)是基于彼得罗斯和乌尔姆斯坦提出的压力性尿失禁病理生理学理论。在他们的“整体理论”中,耻骨尿道韧带损伤是压力性尿失禁的主要原因之一。经闭孔吊带术被发现对压力性尿失禁患者有效,围手术期并发症和排尿困难的发生率较低。压力性尿失禁女性中也可能出现子宫/阴道顶端和阴道后壁脱垂。有许多用于矫正盆腔器官脱垂的手术。近年来已开发出使用聚丙烯网片经阴道修复前后盆腔脱垂的方法。有必要评估和比较目前的治疗效果质量。