Sander P, Lose G
Department of Obstetrics and Gynaecology, Glostrup County Hospital, University of Copenhagen, Copenhagen, Denmark.
Minerva Ginecol. 2007 Dec;59(6):619-27.
The aim of this review is to provide an update on the surgical options for treatment of stress incontinence in women. The efficiency of different procedures and the safety associated with each procedure are evaluated, mainly by reviewing the randomised controlled trials. The open retropubic colposuspension and the sling procedures are the most efficacious for treatment stress urinary incontinence especially in the long term. The laparoscopic colposuspension may be as good as the open colposuspension, but the long-term performance remains uncertain. The newer minimal access vaginal sling procedures appear to offer benefits of minimal access surgery with success rate similar to the colposuspension and the traditional slings and minor morbidity in the short and median-term. However long term data is still awaited. The transobturator technique does not seem to provide advantages compared to the classical TVT procedure. Urethral injection therapy does not seem to have the same efficacy as conventional surgery and long term data is still scanty. However, because of low operative morbidity it represents a favourable alternative to standard surgery in patients who prefer less invasive treatment, the frail elderly and other selected women where conventional surgery is problematic.
本综述的目的是提供女性压力性尿失禁外科治疗选择的最新情况。主要通过回顾随机对照试验来评估不同手术方法的疗效以及每种手术方法的安全性。耻骨后开放式阴道膀胱颈悬吊术和吊带手术对治疗压力性尿失禁最为有效，尤其是从长期来看。腹腔镜阴道膀胱颈悬吊术可能与开放式手术效果相当，但长期效果仍不确定。更新的微创阴道吊带手术似乎具有微创手术的优势，成功率与阴道膀胱颈悬吊术和传统吊带手术相似，短期和中期并发症较少。然而，仍有待长期数据。与经典经阴道无张力尿道中段悬吊术（TVT）相比，经闭孔技术似乎没有优势。尿道注射疗法的疗效似乎不如传统手术，且长期数据仍然匮乏。然而，由于手术并发症发生率低，对于倾向于侵入性较小治疗的患者、体弱的老年人以及传统手术存在问题的其他特定女性来说，它是标准手术的一个有利替代方案。
