U 形位置的经闭孔无张力尿道中段悬吊术——解剖学研究
TVT-S in the U position--anatomical study.
作者信息
Hubka Petr, Nanka Ondrej, Martan Alois, Grim Milos, Zvarova Jana, Masata Jaromir
机构信息
First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Charles University in Prague, Apolinarska 18, Prague 2, 12000, Czech Republic.
出版信息
Int Urogynecol J. 2011 Feb;22(2):241-6. doi: 10.1007/s00192-010-1239-5. Epub 2010 Aug 27.
INTRODUCTION AND HYPOTHESIS
The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site.
METHODS
We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle.
RESULTS
In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05).
CONCLUSIONS
There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.
引言与假设
目的是描述无张力阴道吊带Secur（TVT-S）在U形位置时与可能的损伤及固定部位相关的解剖位置。
方法
我们在13具防腐处理的女性尸体和5具新鲜冷冻的女性尸体双侧放置TVT-S插入器。解剖后，我们测量了距闭孔束的距离。
结果
在防腐处理的尸体中，TVT-S距左侧闭孔束的平均距离为2.83厘米（标准差（SD）0.87厘米），右侧为2.92厘米（SD 1.24厘米）。闭孔内肌筋膜穿孔发生率为38.5%。在新鲜冷冻尸体中，结果基本相似（p>0.05）。
结论
在TVT-S手术过程中存在损伤闭孔束和膀胱的风险；然而，将TVT-S插入器插入闭孔内肌外侧（进入小骨盆）的风险很大。腿部位置不当后，TVT-S的位置没有明显变化。
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