Stolz W, Brandner P, Dory F, Bastert G
Universitäts-Frauenklinik Homburg/Saar.
Geburtshilfe Frauenheilkd. 1989 Jun;49(6):564-7. doi: 10.1055/s-2008-1035840.
Since broad experience concerning the stability of fibrin sealing is needed, it has become part of the routine program in orthopaedics and in traumatology. Because of these experiences, we decided to modify the standard Marshall-Marchetti-Krantz-Operation replacing all sutures on both sides of the urethra and the bladder neck by fibrin sealing. So far, 76 patients have been operated using to this new method. All patients had a urinary stress incontinence grade II-III, urodynamically verified and a pronounced urethro-cystocele. To judge the results of the operation the following check-ups were instituted: 1. Urodynamic control, 2. lateral cyst-urethrogram, 3. gynecological examination (anatomical control), 4. subjective, individual evaluation of the patient concerning the involuntary loss of urine. Our study shows that we achieved good surgical and functional results as can be demonstrated both clinically and by urodynamic check-up. The advantage of this method of operation using fibrin sealing is to be seen in the broad lifting up of the anterior vaginal wall without unphysiological fixation and at the same time avoiding all risks of sutures.
由于需要有关纤维蛋白封闭稳定性的广泛经验，它已成为骨科和创伤学常规程序的一部分。基于这些经验，我们决定对标准的马歇尔-马凯蒂-克兰茨手术进行改良，用纤维蛋白封闭替代尿道和膀胱颈两侧的所有缝线。到目前为止，已有76例患者采用这种新方法进行了手术。所有患者均有II-III级压力性尿失禁，经尿动力学证实，且有明显的尿道膀胱膨出。为评估手术效果，进行了以下检查：1. 尿动力学检查；2. 膀胱尿道侧位造影；3. 妇科检查（解剖学检查）；4. 患者对尿失禁的主观个体评估。我们的研究表明，无论是临床还是尿动力学检查都显示，我们取得了良好的手术和功能效果。这种使用纤维蛋白封闭的手术方法的优点在于能广泛提升阴道前壁，而无需进行非生理性固定，同时避免了缝线的所有风险。
