Ralph G, Lichtenegger W, Tamussino K
Universitäts-Frauenklinik, Graz.
Zentralbl Gynakol. 1989;111(4):235-42.
184 women who underwent surgery because of stress incontinence during the years 1982-1986 were examined both before and after surgery. The interval between operation and post operational control was from 12 to 60 months. After colporrhaphy anterior and colcoperineoplasty 69% of the women were continent; 14% showed a stress incontinence of first degree, 17% a stress incontinence of second degree. After Marshall-Marchetti 75% of the patients were continent; 16% were stress incontinent to degree I. The best result was achieved by lifting the neck of the bladder (Stamey-method): 82% of the women were continent, 18% stress incontinent. The urethral closure pressure at rest went down significantly after colporrhaphia anterior; it rose slightly after Marshall-Marchetti and the endoscopic lifting of the bladder neck (Stamey-method). All postoperatively continent women showed an improval of pressure transmission, the best result having been achieved after the endoscopic lifting of the bladder neck (Stamey-method). Contrary to colporrhaphia anterior and colpoperineoplasty the miction was impaired after abdominal operational methods. The results will be shown and discussed.
1982年至1986年间因压力性尿失禁接受手术的184名女性在手术前后均接受了检查。手术与术后复查的间隔时间为12至60个月。经阴道前壁修补术和会阴修补术后,69%的女性尿失禁症状消失;14%表现为一度压力性尿失禁,17%为二度压力性尿失禁。经马歇尔 - 马切蒂手术(Marshall-Marchetti)后,75%的患者尿失禁症状消失;16%为一度压力性尿失禁。通过膀胱颈悬吊术(斯塔米法,Stamey-method)取得了最佳效果:82%的女性尿失禁症状消失,18%为压力性尿失禁。经阴道前壁修补术后静息时尿道闭合压显著下降;经马歇尔 - 马切蒂手术以及膀胱颈内镜悬吊术(斯塔米法)后略有上升。所有术后尿失禁症状消失的女性压力传导均有所改善,膀胱颈内镜悬吊术(斯塔米法)取得的效果最佳。与经阴道前壁修补术和会阴修补术相反,腹部手术方法术后排尿功能受到影响。结果将予以展示和讨论。