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[使用聚四氟乙烯吊带行经尿道下悬吊术治疗女性压力性尿失禁。附95例报告]

[Surgical treatment of stress urinary incontinence in women using a suburethral suspension with a polytetrafluoroethylene sling. Apropos of 95 cases].

作者信息

Mouchel J

出版信息

Rev Fr Gynecol Obstet. 1990 Jun;85(6):399-406.

PMID:2202042
Abstract

Description of a new technique for urethral support which complies with the usual criteria for the efficacy of a surgical cure for stress incontinence without having any of its disadvantages. Presentation of the results, postoperative complications and of the potential role of endovaginal echography in preoperative assessment and follow up. The method can be characterized by: its safety, thanks to the vaginal approach across an operative field the size of a postage stamp, ensuring an uncomplicated postoperative period and a short stay in hospital; its accuracy in suburethral support provided by a strip of expanded polytetrafluoroethylene (Gore-tex soft tissue patch), 30 mm by 10 mm, fixed at the ends to the public insertion of the pubococcygeal tract of the levator muscles, and by its median part to the vesicourethral junction: it is of unrivalled precision, thanks to the peroperative use of an urethrometer which is introduced into the urethra to a certain determined length, either by the application of the formula: urethral length = functional length + 8 mm or, better, from a knowledge of the anatomical length measured between the meatus and the origin of the sphincteral zone during prior endovaginal echography; its efficacy, since the results are stable over time and are obtained without dysuria. These characteristics should make it a first line treatment in the therapeutic arsenal for stress incontinence.

摘要

一种新型尿道支撑技术的描述,该技术符合压力性尿失禁手术治疗疗效的常规标准,且无其任何缺点。介绍了该技术的结果、术后并发症以及经阴道超声检查在术前评估和随访中的潜在作用。该方法的特点包括:安全性高,因为通过阴道入路,手术视野仅邮票大小,确保术后恢复顺利且住院时间短;精确性高,通过一条30毫米×10毫米的膨体聚四氟乙烯(戈尔特斯软组织补片)提供尿道下支撑,补片两端固定于耻骨尾骨肌耻骨插入部,中间部分固定于膀胱尿道交界处;精确性无与伦比,因为术中使用尿道测量仪,通过应用公式“尿道长度=功能长度+8毫米”,或者更好的是,根据术前经阴道超声检查测量的尿道口与括约肌区起点之间的解剖长度,将其插入尿道至特定确定长度;有效性高,因为随着时间推移结果稳定且无排尿困难。这些特性应使其成为压力性尿失禁治疗手段中的一线治疗方法。

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