Jones D J, Shah P J, Worth P H
St Peter's Hospital, Institute of Urology, London.
Br J Urol. 1989 Feb;63(2):157-61. doi: 10.1111/j.1464-410x.1989.tb05155.x.
A review of 76 patients who underwent endoscopic bladder neck suspension (EBNS) for stress incontinence is presented. Pre-operative video-urodynamic studies in 71 patients demonstrated stable stress incontinence in 61 (86%). There was a history of previous pelvic surgery in 52 patients (68%). Surgery was performed by trainee urologists in 35 cases (46%). The overall complication rate was 46%, of which 17% were per-operative and did not influence the outcome of surgery. Infection occurred in 16% and necessitated removal of the suture buffers in 9%. Follow-up ranged from 7 to 30 months (mean 18.3). Complete resolution of stress incontinence or a marked improvement in symptoms was seen in 86% of cases. Patients with no history of previous pelvic surgery were all either cured or improved by the procedure. Of the 52 patients who had undergone previous pelvic surgery, 42 (80%) were either cured or improved. All of the 10 failures were in this group. There was no difference between complication or success rates achieved by consultants or urologists in training. It was concluded that EBNS is the treatment of choice in patients with primary stress incontinence and it is an effective procedure in patients who have undergone previous unsuccessful surgery for stress incontinence.
本文介绍了76例因压力性尿失禁接受内镜下膀胱颈悬吊术（EBNS）的患者情况。71例患者术前的影像尿动力学研究显示，61例（86%）存在持续性压力性尿失禁。52例患者（68%）有既往盆腔手术史。35例（46%）手术由泌尿外科实习医生完成。总体并发症发生率为46%，其中17%为术中并发症，未影响手术结果。16%发生感染，9%需要取出缝线缓冲物。随访时间为7至30个月（平均18.3个月）。86%的病例压力性尿失禁完全缓解或症状明显改善。无既往盆腔手术史的患者均通过该手术治愈或改善。在52例有既往盆腔手术史的患者中，42例（80%）治愈或改善。所有10例手术失败的患者均在该组。顾问医生或实习泌尿外科医生的并发症或成功率无差异。结论是，EBNS是原发性压力性尿失禁患者的首选治疗方法，对于既往压力性尿失禁手术失败的患者也是一种有效的手术方法。
