Raz S, Siegel A L, Short J L, Snyder J A
Division of Urology, University of California School of Medicine, Los Angeles.
J Urol. 1989 Jan;141(1):43-6. doi: 10.1016/s0022-5347(17)40581-7.
We describe a new technique for the treatment of urinary incontinence due to intrinsic sphincteric damage in which a sling constructed from vaginal wall is used to provide compression and support of the urethra. A rectangular island of in situ anterior vaginal wall underlying the urethra and bladder neck is developed, the 4 corners are anchored with polypropylene sutures and a ligature carrier is used to transfer the sutures to a suprapubic location. An anterior vaginal wall flap proximal to the island is advanced to cover the island. When the sutures are tied the resulting sling will support the urethra and increase urethral resistance by compression, restoring continence. The advantages are its simplicity, need for only a small incision, short operative time and hospital stay, and reliance on healthy, well vascularized, in situ tissue. Continence has been achieved in 29 of 32 cases. All patients voided spontaneously except for those with neuropathic urethral incompetence who required self-catheterization.
我们描述了一种治疗因内在括约肌损伤导致尿失禁的新技术，该技术使用由阴道壁构建的吊带对尿道进行压迫和支撑。在尿道和膀胱颈下方制作一个原位阴道前壁矩形岛状组织，其四个角用聚丙烯缝线固定，并用结扎器将缝线转移至耻骨上位置。在岛状组织近端推进一块阴道前壁皮瓣以覆盖该岛状组织。当缝线打结时，形成的吊带将支撑尿道并通过压迫增加尿道阻力，从而恢复控尿功能。其优点包括操作简单、只需小切口、手术时间短和住院时间短，且依赖于健康、血运良好的原位组织。32例患者中有29例实现了控尿。除了患有神经性尿道功能不全需要自行导尿的患者外，所有患者均能自主排尿。
