Kociszewski Jacek, Fabian George, Grothey Susanne, Kuszka Andrzej, Zwierzchowska Aneta, Majkusiak Wojciech, Barcz Ewa
Department of Gynecology and Obstetrics, Evangelical Hospital Hagen-Haspe, Hagen, Germany.
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
Int J Urol. 2017 Feb;24(2):145-150. doi: 10.1111/iju.13262. Epub 2016 Dec 1.
To evaluate whether the sling position is associated with particular types of complications in patients undergoing suburethral sling placement for stress urinary incontinence.
Data from 100 women diagnosed at the Evangelical Hospital Hagen-Haspe with complications after suburethral sling insertion were analyzed. All patients underwent pelvic floor ultrasound to assess: urethral length, sling location in relation to the urethral length (%) and the sling distance to the longitudinal smooth muscle complex of the urethra (the sling-longitudinal smooth muscle distance).
The shortest median sling-longitudinal smooth muscle distance was observed in patients with recurrent urinary tract infections, urinary retention and overactive bladder: 0.9, 1.1 and 1.75 mm, respectively (P < 0.05). In women with persistent stress urinary incontinence and sling erosion, the sling-longitudinal smooth muscle distance was 3.6 and 4.6 mm, respectively (P < 0.05). Persistent stress urinary incontinence was connected with the position of the sling in relation to the bladder neck - in these patients, the sling was closer to the bladder neck.
Sling location plays a pivotal role in the occurrence of certain complications. The sling position in the proximal part of the urethra or between the middle and proximal urethra appears to be connected with a high rate of unsuccessful stress urinary incontinence treatment. A sling-longitudinal smooth muscle distance below 2 mm is often connected with sling complications, such as overactive bladder, urinary retention and recurrent urinary tract infections.
评估在接受尿道下吊带置入术治疗压力性尿失禁的患者中，吊带位置是否与特定类型的并发症相关。
对哈根 - 哈斯佩福音医院诊断为尿道下吊带置入术后出现并发症的100名女性的数据进行分析。所有患者均接受盆底超声检查以评估：尿道长度、吊带相对于尿道长度的位置（%）以及吊带与尿道纵向平滑肌复合体的距离（吊带 - 纵向平滑肌距离）。
复发性尿路感染、尿潴留和膀胱过度活动症患者的吊带 - 纵向平滑肌距离中位数最短，分别为0.9、1.1和1.75毫米（P < 0.05）。持续性压力性尿失禁和吊带侵蚀的女性患者，吊带 - 纵向平滑肌距离分别为3.6和4.6毫米（P < 0.05）。持续性压力性尿失禁与吊带相对于膀胱颈的位置有关——在这些患者中，吊带更靠近膀胱颈。
吊带位置在某些并发症的发生中起关键作用。尿道近端或尿道中、近端之间的吊带位置似乎与压力性尿失禁治疗成功率低相关。吊带 - 纵向平滑肌距离低于2毫米通常与吊带并发症有关，如膀胱过度活动症、尿潴留和复发性尿路感染。
