McKertich Karen
Urology Department, Cabrini Medical Centre and The Alfred Hospital, Melbourne, Victoria.
Aust Fam Physician. 2008 Mar;37(3):122-31.
A range of surgical treatment options is available for women suffering from stress and urge urinary incontinence refractory to conservative and medical management.
This article discusses the indications for surgical treatments for stress and urge urinary incontinence in women; and the advantages, disadvantages and side effects of these treatments.
Women who fail to respond to pelvic floor physiotherapy for stress urinary incontinence have available to them a range of variably invasive surgical treatment options including bio-injectable agents, sling surgery, colposuspension, and prostheses. Women with urge urinary incontinence refractory to the newer anticholinergic agents can be treated with minimally invasive options such as bladder injections of botulinum toxin and sacral neuromodulation, as well as more invasive major urinary tract surgery.
对于那些经保守治疗和药物治疗后仍难治愈的压力性和急迫性尿失禁女性患者，有一系列手术治疗方案可供选择。
本文讨论女性压力性和急迫性尿失禁的手术治疗适应证，以及这些治疗方法的优缺点和副作用。
对于压力性尿失禁患者，盆底物理治疗无效时，有一系列不同程度侵入性的手术治疗方案可供选择，包括生物可注射剂、吊带手术、阴道前壁修补术和假体植入。对于使用新型抗胆碱能药物治疗无效的急迫性尿失禁女性患者，可采用微创治疗方法，如膀胱注射肉毒杆菌毒素和骶神经调节，以及侵入性更强的主要尿路手术。
