Bergman A, Koonings P P, Ballard C A
Department of Obstetrics and Gynecology, Women's Hospital, Los Angeles County/University of Southern California Medical Center 90033.
J Reprod Med. 1989 Mar;34(3):193-7.
Fifteen women with a clinical and urodynamic diagnosis of stress urinary incontinence had a negative Q-tip test (greater than or equal to 30 degrees Q-tip angle change on straining). All 15 had retropubic surgical procedures for stress incontinence in the form of a revised Pereyra procedure (n = 6) or Burch retropubic urethropexy (n = 9). Five of the nine patients undergoing the Burch procedure (55%) and three of the six undergoing the Peyreya procedure (50%) failed the procedure, for an overall failure rate of 53%. This rate was five times higher than that among women with stress urinary incontinence and a positive Q-tip test who underwent the same procedures (P less than .01). We conclude that women with stress urinary incontinence and no anatomic defect in the support of the urethrovesical junction should not undergo retropubic procedures because of their high failure rate. Other occlusive procedures, such as sling operations, should be considered for this group.
15名经临床和尿动力学诊断为压力性尿失禁的女性，棉签试验结果为阴性（用力时棉签角度变化大于或等于30度）。这15名患者均接受了耻骨后手术治疗压力性尿失禁，手术方式为改良佩雷拉手术（n = 6）或伯奇耻骨后尿道悬吊术（n = 9）。接受伯奇手术的9名患者中有5名（55%）手术失败，接受佩雷拉手术的6名患者中有3名（50%）手术失败，总体失败率为53%。该失败率比压力性尿失禁且棉签试验结果为阳性并接受相同手术的女性高出五倍（P <.01）。我们得出结论，压力性尿失禁且尿道膀胱连接部无解剖缺陷的女性，不应因手术失败率高而接受耻骨后手术。对于该组患者，应考虑其他闭塞性手术，如吊带手术。
