Misrai Vincent, Rouprêt Morgan, Xylinas Evanguelos, Cour Florence, Vaessen Christophe, Haertig Alain, Richard François, Chartier-Kastler Emmanuel
Department of Urology, Groupe Hospitalo-Universitaire EST, Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France.
J Urol. 2009 May;181(5):2198-202; discussion 2203. doi: 10.1016/j.juro.2009.01.036. Epub 2009 Mar 17.
Suburethral tapes have been widely adopted to treat stress urinary incontinence. Further resection of such tapes may be necessary in certain cases. We review our experience and assess urinary functional outcomes.
We retrospectively reviewed the data on all women referred to our institution between 2001 and 2007 for suburethral tape related complications and on those who had the tape surgically removed. Complete or partial resection was achieved after assessment, including endoscopic and urodynamic assessment.
A total of 75 women with a mean age of 60.7 years (range 28 to 78) were included in the study. The tape used was transvaginal in 58 cases (77.3%) and transobturator in 17 (22.7%). There were different complications, such as erosion in 16% of cases, vaginal extrusion in 24%, bladder outlet obstruction in 45%, chronic pelvic pain in 21%, and de novo urinary incontinence and urgency in 12%. Resection was done a mean +/- SD of 33 +/- 22 months (range 6 to 80) after tape placement. Of the 58 women with transvaginal tape the tape was completely removed by laparoscopy in 30 (51%). Four of the 17 transobturator slings (23%) were completely removed by laparoscopy (1) and via a low gynecological approach (3). The remaining slings were partially resected via a gynecological approach. At a mean followup of 38.4 months (range 12 to 72) incontinence recurred in 39 women (52%) after partial (18) and complete (21) resection.
In rare women who experience crippling symptoms after suburethral sling implantation urologists must be aware that the decision to completely or partially resect the tape can help resolve symptoms.
耻骨后尿道悬吊术已被广泛用于治疗压力性尿失禁。在某些情况下，可能需要进一步切除此类吊带。我们回顾了我们的经验并评估了尿功能结果。
我们回顾性分析了2001年至2007年间因耻骨后尿道吊带相关并发症转诊至我院的所有女性以及接受吊带手术切除的女性的数据。在评估后进行了完全或部分切除，包括内镜和尿动力学评估。
共有75名平均年龄为60.7岁（范围28至78岁）的女性纳入研究。使用的吊带中，经阴道的有58例（77.3%），经闭孔的有17例（22.7%）。出现了不同的并发症，如16%的病例有侵蚀，24%的病例有阴道脱垂，45%的病例有膀胱出口梗阻，21%的病例有慢性盆腔疼痛，12%的病例有新发尿失禁和尿急。吊带放置后平均±标准差33±22个月（范围6至80个月）进行了切除。在58例经阴道吊带的女性中，30例（51%）通过腹腔镜完全切除了吊带。17例经闭孔吊带中的4例（23%）通过腹腔镜（1例）和低位妇科手术途径（3例）完全切除。其余吊带通过妇科手术途径进行了部分切除。平均随访38.4个月（范围12至72个月），部分（18例）和完全（21例）切除后，39名女性（52%）出现了尿失禁复发。
对于少数在耻骨后尿道吊带植入后出现严重症状的女性，泌尿外科医生必须意识到完全或部分切除吊带的决定有助于缓解症状。
