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[Burch阴道悬吊术的功能和尿动力学结果。173例系列研究]

[Functional and urodynamic results of Burch's colpopexy. A series of 173 cases].

作者信息

Guerinoni L, Treisser A, Klein P, Renaud R

机构信息

Clinique Gynécologique et Obstétricale, Maternité et Ecole de Sages-Femmes, CHRU de Strasbourg.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1991;20(2):231-40.

PMID:2071868
Abstract

The authors describe their experience with modified Burch retropubic urethropexy with a mean follow-up of 4 1/2 years; they clinically assessed 173 women. 114 of these had urodynamic studies. The long term objective success of this operative procedure, with a success rate of 95% in genuine stress incontinence and of 96% in correction of the cystocele, justify its use to cure urine loss in women with primary stress incontinence or after failure of a previous operation. The results do not get worse with a long term follow-up. The mechanism of action consists in improving the abdominal pressure transmission ration (+29%) with only a little decrease of the post-operative mean maximal urethral closure pressure (-8,8 cm H2O). The most challenging complication encountered was bladder instability (22.5%); post-operative retrocele or enterocele occurred in 15% of cases. The other side effects were dysuria, pubic pain and trachelocele. The rate of failure is nearly 5% mainly due to insufficient correction of the abdominal pressure transmission ration, or post-operative bladder instability or low urethral closure pressure.

摘要

作者描述了他们采用改良耻骨后尿道悬吊术的经验,平均随访时间为4.5年;他们对173名女性进行了临床评估。其中114人进行了尿动力学研究。该手术的长期客观成功率在真性压力性尿失禁患者中为95%,在膀胱膨出矫正中为96%,这证明其可用于治疗原发性压力性尿失禁女性或既往手术失败后的尿失禁。长期随访结果并未恶化。其作用机制在于提高腹压传递率(提高29%),而术后平均最大尿道闭合压仅略有下降(下降8.8 cm H₂O)。遇到的最具挑战性的并发症是膀胱不稳定(22.5%);15%的病例出现术后阴道后疝或肠疝。其他副作用包括排尿困难、耻骨疼痛和子宫脱垂。失败率约为5%,主要原因是腹压传递率矫正不足、术后膀胱不稳定或尿道闭合压过低。

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