de Gregorio G, Stein B, Kaltenbach F J, Hillemanns H G
Universitätsfrauenklinik Freiburg.
Geburtshilfe Frauenheilkd. 1990 Jul;50(7):548-51. doi: 10.1055/s-2008-1026299.
This study examines the pre- and postoperative clinical data of 215 women operated on during 1983-87 at the University Hospital of Freiburg for stress incontinence. The following procedures were used: Anterior colporrhaphy (n = 27), anterior colporrhaphy in combination with a ventral levator plasty (n = 61), sling procedure with the Lyodura sling (n = 44), and a colposuspension within the total abdominal concept (n = 83). All the procedures, with the exception of anterior colporrhaphy, were followed by a decrease in maximum urethral pressure. The functional urethral length was not changed by any of the methods. Colposuspension showed a marked postoperative improvement of urethral stress profile parameters in the proximal and midurethra, the sling had a steep, unphysiological increase of pressure transmission ratio in the proximal urethra. The vaginal methods did not improve pressure transmission to the proximal section of the urethra, their effect was only measurable in the mid section. The urodynamic effects of different types of surgery were very individual, a fact which may be helpful in the selection of the surgical approach.
本研究调查了1983年至1987年期间在弗赖堡大学医院接受压力性尿失禁手术的215名女性的术前和术后临床数据。采用了以下手术方法：前阴道壁修补术（n = 27）、前阴道壁修补术联合腹侧提肌成形术（n = 61）、使用Lyodura吊带的吊带手术（n = 44）以及全腹式概念下的阴道悬吊术（n = 83）。除前阴道壁修补术外，所有手术术后最大尿道压力均下降。所有方法均未改变功能性尿道长度。阴道悬吊术显示术后尿道近端和中段压力分布参数有明显改善，吊带手术使尿道近端压力传递率急剧且不符合生理地升高。阴道手术方法并未改善向尿道近端的压力传递，其效果仅在中段可测量。不同类型手术的尿动力学效应差异很大，这一事实可能有助于手术方式的选择。
