Ramon J, Mekras J A, Webster G D
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
J Urol. 1990 Jul;144(1):106-8; discussion 108-9. doi: 10.1016/s0022-5347(17)39382-5.
Preoperative urodynamic and radiographic evaluation identified features of bladder neck and urethral weakness in 62 women undergoing cystourethropexy for the correction of anatomical stress urinary incontinence. Despite the coexistence of anatomical and outlet factors persistent stress incontinence due to intrinsic urethral weakness occurred in only 2 patients (3%), neither of whom was identifiable by preoperative urethral function evaluation. Preoperative coexisting urgency symptoms had no impact on the surgical outcome, resolving in the majority of patients with sensory urgency and responding to alternate postoperative management in those with bladder instability. We conclude that anatomical correction by cystourethropexy is appropriate for women with mixed etiology incontinence in whom urethrovesical hypermobility is present.
术前尿动力学和影像学评估发现，62例因解剖性压力性尿失禁接受膀胱尿道悬吊术的女性存在膀胱颈和尿道薄弱的特征。尽管存在解剖学和出口因素，但仅2例患者（3%）因内在尿道薄弱出现持续性压力性尿失禁，术前尿道功能评估均未识别出这两例患者。术前并存的尿急症状对手术结果无影响，大多数感觉性尿急患者症状缓解，膀胱不稳定患者经术后其他处理后症状改善。我们得出结论，对于存在尿道膀胱过度活动的混合病因尿失禁女性，膀胱尿道悬吊术进行解剖学矫正较为合适。
