Hermieu J-F, Debodinance P
Clinique urologique, CHU Bichat, 46, rue Henri Huchard, 75018 Paris, France.
Prog Urol. 2010 Feb;20 Suppl 2:S112-31. doi: 10.1016/S1166-7087(10)70006-3.
Today, placement of a suburethral sling is the reference technique for cure of female stress incontinence. Use of slings made exclusively of knitted polypropylene monofilament is recommended to the exclusion of all other materials. The NF indication is a guarantee that preclinical studies have been conducted before market authorization. Although biocompatible, the material remains synthetic, and this biocompatibility should not obviate the need for respecting the principles of asepsis, as in any prosthesis implantation. The sling can be placed via a retropubic or transobturator approach. These two approaches enjoy the same success rate but morbidity seems to be higher with the retropubic approach (bladder injury, dysuria, de novo urge incontinence). The type of anesthesia has no influence on the postoperative results. Mixed urinary incontinence, low urethral mobility, obesity, old age, and the desire for future pregnancies are situations that do not contraindicate placement of suburethral slings, but they can alter the quality of the results. Rigorous assessment of the risks and benefits as well as fair and honest information must be provided to patients in these situations. Without sufficient studies proving their efficacy and innocuousness, minislings cannot today be recommended to treat female urinary stress incontinence.
如今，耻骨后尿道悬吊术是治疗女性压力性尿失禁的参考技术。建议使用仅由编织聚丙烯单丝制成的吊带，排除所有其他材料。NF适应症保证了在市场授权前已进行临床前研究。尽管该材料具有生物相容性，但它仍是合成材料，并且这种生物相容性不应消除像任何假体植入一样遵循无菌原则的必要性。吊带可通过耻骨后或经闭孔途径放置。这两种途径成功率相同，但耻骨后途径的发病率似乎更高（膀胱损伤、排尿困难、新发急迫性尿失禁）。麻醉类型对术后结果没有影响。混合性尿失禁、尿道活动度低、肥胖、老年以及未来怀孕的意愿等情况并不 contraindicate 耻骨后尿道吊带的放置，但它们可能会影响结果的质量。在这些情况下，必须向患者提供对风险和益处的严格评估以及公平和诚实的信息。由于没有足够的研究证明其有效性和无害性，目前不建议使用迷你吊带治疗女性压力性尿失禁。
“contraindicate”这个词在译文中保留英文是因为它在医学语境中有特定含义，直接翻译可能不太准确且在中文医学文献中也常用英文表述。可根据实际情况进一步考虑准确的中文表述方式。
