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前路阴道修补术不会引起膀胱出口梗阻。

Anterior colporrhaphy does not induce bladder outlet obstruction.

作者信息

Lakeman M M E, Hakvoort R A, Van de Weijer E P, Emanuel M H, Roovers J P W R

机构信息

Department of Obstetrics and Gynaecology, Academic Medical Centre, Room H4-205, PO Box 22700, 1105 DE Amsterdam, The Netherlands.

出版信息

Int Urogynecol J. 2012 Jun;23(6):723-8. doi: 10.1007/s00192-012-1688-0.

Abstract

INTRODUCTION AND HYPOTHESIS

We aimed to evaluate if anterior colporrhaphy causes incomplete voiding due to bladder outlet obstruction.

METHODS

Women scheduled for anterior colporrhaphy were asked to undergo multichannel urodynamic investigation before surgery and the first postoperative day. Bladder outlet obstruction was assessed using the Blaivas–Groutz voiding nomogram. Maximum flow rate, detrusor pressure and residual volume were compared between pre- and postoperative measurements and between women with and without an abnormal post-void residual volume (PVR; volume exceeding 150 ml).

RESULTS

Seventeen women participated. One woman who was unobstructed before surgery was obstructed after surgery. Overall, detrusor pressure and maximum flow rate before and after surgery did not differ. After surgery, six women had an abnormal PVR, one was unable to void, four were mildly obstructed and one moderately obstructed.

CONCLUSION

Urodynamic investigation the first day after anterior colporrhaphy did not show that anterior colporrhaphy induces bladder outlet obstruction. The explanation for postoperative urinary retention can therefore also lie in nonanatomical causes such as postoperative pain and psychological factors.

摘要

引言与假设

我们旨在评估前阴道壁修补术是否会因膀胱出口梗阻导致排尿不完全。

方法

计划进行前阴道壁修补术的女性在手术前及术后第一天被要求接受多通道尿动力学检查。使用布莱瓦斯-格劳茨排尿列线图评估膀胱出口梗阻情况。比较术前和术后测量值之间以及有和没有异常排尿后残余尿量(PVR;超过150毫升的尿量)的女性之间的最大尿流率、逼尿肌压力和残余尿量。

结果

17名女性参与。一名术前无梗阻的女性术后出现梗阻。总体而言,手术前后的逼尿肌压力和最大尿流率没有差异。术后,6名女性有异常PVR,1名无法排尿,4名轻度梗阻,1名中度梗阻。

结论

前阴道壁修补术后第一天的尿动力学检查未显示前阴道壁修补术会导致膀胱出口梗阻。因此,术后尿潴留的原因也可能在于非解剖学因素,如术后疼痛和心理因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60f3/3357473/d770238ef8b4/192_2012_1688_Fig1_HTML.jpg

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