Kil P J, Hoekstra J W, van der Meijden A P, Smans A J, Theeuwes A G, Schreinemachers L M
Department of Urology, Groot Ziekengasthuis, Hertogenbosch, The Netherlands.
J Urol. 1991 Jul;146(1):132-6. doi: 10.1016/s0022-5347(17)37731-5.
Radiological and ultrasonographic imaging enables the objective determination of bladder neck position and movement in stress urinary incontinence. Postoperative results were evaluated in 60 patients after Burch colposuspension (29) or bladder neck suspension according to the Gittes (18) or Stamey (13) method. No differences in continence rates were noted 3 months postoperatively (Gittes 83%, Stamey 85% and Burch 93% of the patients). Late results were assessed by urodynamic evaluation and transvaginal ultrasonography. The largest decrease in continence rate was observed after the Gittes procedure (44% of the patients continent, mean followup 14.7 months), in comparison with the Stamey (69% continent after 34.6 months) and Burch (86% continent after 30.5 months) procedures. Urodynamic parameters showed no significant differences for the 3 groups. Transvaginal ultrasonography did not indicate a correlation between absolute resting or stress position of the bladder neck and continence. The main factor concerning continence was the rotation angle and descent of the bladder neck during stress. Our data indicate that transvaginal ultrasonography is a safe and reliable method to evaluate the postoperative outcome for stress urinary incontinence.
放射学和超声成像能够客观地确定压力性尿失禁患者膀胱颈的位置和活动情况。对60例行Burch阴道旁修补术（29例）或按照吉特斯（18例）或斯塔米（13例）方法行膀胱颈悬吊术的患者的术后结果进行了评估。术后3个月时，控尿率未见差异（吉特斯手术患者为83%，斯塔米手术患者为85%，Burch手术患者为93%）。通过尿动力学评估和经阴道超声检查评估远期结果。与斯塔米手术（34.6个月后69%控尿）和Burch手术（30.5个月后86%控尿）相比，吉特斯手术术后控尿率下降幅度最大（44%的患者控尿，平均随访14.7个月）。三组的尿动力学参数未见显著差异。经阴道超声检查未显示膀胱颈绝对静息或应力状态位置与控尿之间存在相关性。与控尿有关的主要因素是膀胱颈在应力状态下的旋转角度和下移情况。我们的数据表明，经阴道超声检查是评估压力性尿失禁术后结果的一种安全可靠的方法。
