Klarskov P, Vedel Jepsen P, Dorph S
Department of Urology, Herley Hospital, University of Copenhagen, Denmark.
Acta Radiol. 1988 Nov-Dec;29(6):685-8.
Voiding colpo-cysto-urethrography was performed in 52 consecutive female patients with genuine urinary stress incontinence before treatment and in 50 of the patients after treatment. The patients were randomized to either pelvic floor training or surgery. Surgery included a colposuspension operation in patients with an anterior suspension defect and a vaginal repair in patients with a posterior suspension defect. All pre- and posttreatment examinations were reevaluated blindly by one observer 4 to 6 years later. The pretreatment radiologic reevaluation was in agreement with the original classification in 79 per cent and not in agreement in 21 per cent. Pelvic floor training did not change the degree of suspension defect systematically. The effect of squeezing was significantly improved following pelvic floor training. A colposuspension gave rise to a typical radiologic configuration of the bladder and urethra. A vaginal repair was not detectable radiologically and it did not correct a posterior descent. The degree of descent and the degree of incontinence were not correlated and it was not possible radiologically to distinguish treatment failures from treatment success.
对52例真性尿失禁女性患者在治疗前及其中50例患者在治疗后进行了排尿期膀胱尿道造影。患者被随机分为盆底训练组或手术组。手术包括对存在前悬吊缺陷的患者进行阴道前壁悬吊术，对存在后悬吊缺陷的患者进行阴道修补术。4至6年后，由一名观察者对所有治疗前和治疗后的检查进行盲法重新评估。治疗前的放射学重新评估与原始分类一致的占79%，不一致的占21%。盆底训练并未系统性地改变悬吊缺陷程度。盆底训练后挤压效果得到显著改善。阴道前壁悬吊术产生了典型的膀胱和尿道放射学形态。阴道修补术在放射学上无法检测到，且未纠正后脱垂。脱垂程度与尿失禁程度不相关，从放射学上无法区分治疗失败和治疗成功。
