Gambini-Ricapa Juan, García-Oms Javier, Barea Miguel, Estrada Angeles, Iturri Alejandra, Gambini-Buchon Juan, Gilabert-Estelles Juan
Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain.
Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain.
Int Urogynecol J. 2016 Aug;27(8):1265-72. doi: 10.1007/s00192-016-2958-z. Epub 2016 Feb 10.
We present our 10-year experience in treating stress urinary incontinence (SUI) using a new minisling technique based on a tension-free vaginal tape band designed by our group. The major advantage of this tape is the use of minibelt polypropylene inserted through a single retropubic incision without the use of needles-the Endopelvic Free Anchor (EFA)-based on its location at the midurethra with a U shape. For insertion, each branch is placed using a simple Pean clamp from the vagina with perforation of the endopelvic fascia to achieve a retropubic insertion.
From May 2001 to May 2011, we surgically treated 166 women with primary first- or second-degree SUI due to urethral hypermobility without genital prolapse. All were evaluated according to our study protocol, which included clinical and urodynamic evaluation before and 12 months after surgery.
With a median follow-up of 5 (1-11) years, 152 patients (91.6 %) were fully cured both from urodynamic and subjective points of view. Six patients (3.6 %) had significant improvement, and eight (4.8 %) were identified as technique failure. Complications included one bladder perforation (0.6 %), two cases of postoperative urinary retention (1.24 %), two of retropubic hematoma (1.24 %), and one of de novo urgency (0.6 %). No reinterventions were necessary, and there were no major bleeding complications, no chronic pain or de novo dyspareunia, and no voiding difficulty.
EFA is a viable, safe, and effective technique for treating UI due to urethral hypermobility.
我们介绍了运用基于我们团队设计的无张力阴道吊带带的新型迷你吊带技术治疗压力性尿失禁（SUI）的10年经验。这种吊带的主要优点是使用通过单一耻骨后切口插入的迷你聚丙烯带，无需使用针——基于其位于尿道中段呈U形的位置，即盆腔内游离锚定（EFA）。插入时，使用简单的佩恩钳从阴道放置每个分支，穿过盆腔内筋膜以实现耻骨后插入。
2001年5月至2011年5月，我们对166例因尿道活动过度且无生殖器脱垂而患有原发性一度或二度SUI的女性进行了手术治疗。所有患者均按照我们的研究方案进行评估，该方案包括手术前和手术后12个月的临床及尿动力学评估。
中位随访时间为5（1 - 11）年，从尿动力学和主观角度来看，152例患者（91.6%）完全治愈。6例患者（3.6%）有显著改善，8例（4.8%）被认定为技术失败。并发症包括1例膀胱穿孔（0.6%）、2例术后尿潴留（1.24%）、2例耻骨后血肿（1.24%）和1例新发尿急（0.6%）。无需再次干预，无重大出血并发症，无慢性疼痛或新发性交困难，也无排尿困难。
EFA是一种治疗因尿道活动过度导致的尿失禁可行、安全且有效的技术。
