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尿道下吊带术后膀胱内网片经尿道切除术治疗压力性尿失禁的疗效

Outcomes of transurethral resection (TUR) of intravesical mesh after suburethral slings in the treatment of urinary stress incontinence.

作者信息

Castroviejo-Royo F, Rodríguez-Toves L A, Martínez-Sagarra-Oceja J M, Conde-Redondo C, Mainez-Rodríguez J A

机构信息

Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España.

Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España.

出版信息

Actas Urol Esp. 2015 Apr;39(3):183-7. doi: 10.1016/j.acuro.2014.09.006. Epub 2014 Nov 4.

Abstract

OBJECTIVE

The objective of this study was to determine the efficacy as well as the complications associated with transurethral removal (TUR) of intravesical mesh after suburethral sling, transobturator tape-TOT (Monarc™) or "minisling" (MiniArc(®)), in the treatment of female urinary stress incontinence (USI).

MATERIAL AND METHODS

retrospective and consecutive study on 9 women with bladder perforation after midurethral slings (3 Monarc™ and 6 MiniArc®) placement for urinary stress incontinence. To remove the mesh, transurethral resection with an electrode loop (TUR-E) was used. The technique included: location and total removal of mesh with bipolar resectoscope up to healthy tissue.

RESULTS

The median age was 61 years (49-70 years). The median time between midurethral sling placement and onset the sympltoms was 13 months (1-79 months). and between sling placement and mesh removal was 16 months (1-91 months). Five women (55.5%) developed bladder stones. Mean operating time was 29.4 ± 10.4 minutes and mean length of hospital stay was 2.6 ± 0.5 days. The median follow-up after mesh removal was 38 months (range, 14 to 109 months). No complications were found.

CONCLUSIONS

The use of transurethral resection of intravesical mesh after suburethral slings is easy and the results obtained by our surgical team are excellent.

摘要

目的

本研究的目的是确定经尿道移除尿道下吊带、经闭孔尿道中段悬吊带术(Monarc™)或“迷你吊带”(MiniArc®)后膀胱内补片治疗女性压力性尿失禁(USI)的疗效及并发症。

材料与方法

对9例因压力性尿失禁行尿道中段吊带术(3例Monarc™和6例MiniArc®)后出现膀胱穿孔的女性进行回顾性连续研究。采用电极环经尿道切除术(TUR-E)移除补片。该技术包括:用双极电切镜定位并完全移除补片直至健康组织。

结果

中位年龄为61岁(49 - 70岁)。尿道中段吊带置入与症状出现的中位时间为13个月(1 - 79个月),吊带置入与补片移除的中位时间为16个月(1 - 91个月)。5名女性(55.5%)出现膀胱结石。平均手术时间为29.4 ± 10.4分钟,平均住院时间为2.6 ± 0.5天。补片移除后的中位随访时间为38个月(范围14至109个月),未发现并发症。

结论

尿道下吊带术后经尿道切除膀胱内补片操作简便,我们手术团队取得的效果良好。

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