Tran Henry, Rutman Matthew
Department of Urology, Columbia University, New York, NY.
Department of Urology, Columbia University, New York, NY.
Urology. 2018 Feb;112:1-5. doi: 10.1016/j.urology.2017.08.041. Epub 2017 Sep 6.
Numerous surgical options are available for the management of stress urinary incontinence in women, including urethral bulking agents, pubovaginal slings, retropubic bladder neck suspensions, midurethral slings, and even artificial urinary sphincters. We discuss the incidence, etiology, diagnosis, evaluation, and management of bladder outlet obstruction after anti-incontinence surgery in women. This problem presents with a wide range of symptoms. Urodynamic evaluation is not always diagnostic but can be helpful. Management options range from conservative to invasive. The optimal timeline for intervention is still not well defined, but general guiding principles of management are presented and a comprehensive review of current literature is presented.
有多种手术方法可用于治疗女性压力性尿失禁,包括尿道填充剂、耻骨后阴道吊带术、耻骨后膀胱颈悬吊术、中段尿道吊带术,甚至人工尿道括约肌。我们讨论了女性抗尿失禁手术后膀胱出口梗阻的发生率、病因、诊断、评估和治疗。这个问题表现出广泛的症状。尿动力学评估并不总是具有诊断性,但可能会有所帮助。治疗选择从保守到侵入性不等。干预的最佳时间线仍未明确界定,但我们提出了一般的治疗指导原则,并对当前文献进行了全面综述。