Department of Urology, Concord Repatriation General Hospital, Sydney, Australia.
BJU Int. 2011 Nov;108 Suppl 2:24-8. doi: 10.1111/j.1464-410X.2011.10712.x.
What's known on the subject? and What does the study add? This article provides a current update on the risk factors, clinical features, and diagnosis on obstruction after female stress incontinence surgery using the mid-urethral synthetic sling. Particular attention has been paid to identify the patient at risk for developing voiding difficulty post-sling surgery, as well as the utility of urodynamics and various imaging modalities, especially translabial ultrasound, in the diagnostic process. Urethral obstruction is not an uncommon complication after sling surgery for female stress urinary incontinence (SUI). This paper focuses on this complication in the context of the mid-urethral synthetic sling, which is now the predominate surgical option used by many surgeons in the treatment of female SUI. The epidemiology and risk factors predisposing to sling obstruction is reviewed, followed by a description of clinical features used in supporting the diagnosis. The use of urodynamics in conjunction with translabial ultrasound as a novel approach to assess the position of the sling and its relation to the urethra is explained. This is particularly important in the understanding of why the sling obstructs from an anatomical standpoint. The paper concludes with a brief overview on treatment options.
这方面已知的内容是什么？本研究有何新增内容？本文就女性压力性尿失禁手术中使用的尿道中段合成吊带后发生梗阻的危险因素、临床特征和诊断提供了最新信息。特别注意识别有发生吊带术后排尿困难风险的患者，以及尿动力学和各种成像方式（尤其是经阴道超声）在诊断过程中的应用。尿道梗阻是女性压力性尿失禁（SUI）吊带手术后常见的并发症。本文重点关注尿道中段合成吊带术后的这种并发症，该吊带目前是许多外科医生治疗女性 SUI 的主要手术选择。本文回顾了吊带梗阻的流行病学和危险因素，接着描述了支持诊断的临床特征。本文解释了尿动力学与经阴道超声联合应用作为评估吊带位置及其与尿道关系的新方法，这对于从解剖学角度理解吊带为何梗阻非常重要。本文最后简要概述了治疗选择。
