Bergman A, Koonings P P, Ballard C A
University of Southern California School of Medicine, Women's Hospital, Los Angeles.
Am J Obstet Gynecol. 1989 Jul;161(1):97-101. doi: 10.1016/0002-9378(89)90242-1.
There were 289 women with clinical and urodynamic diagnosis of primary stress urinary incontinence, stable bladder, and pelvic relaxation who underwent a single-stage surgical procedure because of incontinence and pelvic relaxation. Patients underwent one of three surgical procedures because of stress incontinence--anterior colporrhaphy, revised Pereyra procedure, or Burch retropubic urethropexy. Decisions with regard to the type of bladder neck suspension and the surgeon were made randomly with a randomization table. Each patient had a complete clinical and urodynamic evaluation before surgery and at 3 and 12 months after surgery. Cure rate as defined by strict clinical and urodynamic criteria was not significantly different among the three groups at the 3-month postsurgical evaluations; however, at the 12-month postsurgical evaluations, the cure rate among women who underwent Burch urethropexy (n = 101) was significantly higher than that of either Pereyra or anterior colporrhaphy (cure rates were 87%, 70%, and 69%, respectively; p less than 0.01). The Burch urethropexy was more effective than the Pereyra procedure or anterior colporrhaphy in the stabilization of the bladder base and resulted in a significantly better cure rate in women with primary stress urinary incontinence and pelvic relaxation.
有289名经临床和尿动力学诊断为原发性压力性尿失禁、膀胱稳定及盆腔松弛的女性，因尿失禁和盆腔松弛接受了一期外科手术。由于压力性尿失禁，患者接受了三种外科手术之一——阴道前壁修补术、改良佩雷拉手术或伯奇耻骨后尿道悬吊术。膀胱颈悬吊术的类型和手术医生的选择通过随机化表随机确定。每位患者在手术前以及术后3个月和12个月均进行了完整的临床和尿动力学评估。在术后3个月的评估中，三组按照严格的临床和尿动力学标准定义的治愈率无显著差异；然而，在术后12个月的评估中，接受伯奇尿道悬吊术的女性（n = 101）的治愈率显著高于接受佩雷拉手术或阴道前壁修补术的女性（治愈率分别为87%、70%和69%；p < 0.01）。在稳定膀胱底部方面，伯奇尿道悬吊术比佩雷拉手术或阴道前壁修补术更有效，并且在原发性压力性尿失禁和盆腔松弛的女性中治愈率显著更高。
