Hinoul Piet, Roovers Jan-Paul, Ombelet Willem, Vanspauwen Ruben
Ziekenhuis Oost Limburg, Department of Gynaecology, B-3600 Genk, Belgium.
Eur J Obstet Gynecol Reprod Biol. 2009 Aug;145(2):219-25. doi: 10.1016/j.ejogrb.2009.04.020. Epub 2009 May 26.
Urinary incontinence is a highly prevalent condition that has a significant impact on the affected patients' quality of life. Approximately one in three women suffers from some degree of urinary incontinence. Six to ten percent of them are severely affected. Cure or significant improvement can often be achieved after making the right diagnosis, tailoring the treatment accordingly and realistically counseling the patient on the expected outcome. This article focuses on the pathophysiology of genuine or urodynamic stress incontinence (USI) and its surgical management. Until now more than 200 surgical techniques have been described for the treatment of USI. An overview of the historically most important and most commonly used procedures is included. In view of the level I data and the long-term observational studies available on the TVT procedure, it can be considered to be the new gold standard for the treatment of USI.
尿失禁是一种非常普遍的病症,对受影响患者的生活质量有重大影响。大约三分之一的女性患有某种程度的尿失禁。其中6%至10%受到严重影响。做出正确诊断、相应调整治疗方案并如实告知患者预期结果后,通常可以实现治愈或显著改善。本文重点关注真性或尿动力学压力性尿失禁(USI)的病理生理学及其手术治疗。到目前为止,已经描述了200多种治疗USI的手术技术。本文包括对历史上最重要和最常用手术的概述。鉴于有关于经阴道无张力尿道中段吊带术(TVT)的I级数据和长期观察性研究,它可被视为治疗USI的新金标准。