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[妇科术后膀胱排空障碍:病理生理学及治疗可能性]

[Postoperative disorder of bladder emptying in gynecology: pathophysiology and possibilities for treatment].

作者信息

Schüssler B

机构信息

Frauenklinik im Klinikum Grosshadern, Ludwig-Maximilians-Universität München.

出版信息

Geburtshilfe Frauenheilkd. 1988 Aug;48(8):551-8. doi: 10.1055/s-2008-1026537.

Abstract

Urinary retention after radical hysterectomy is due to partial or complete denervation of the bladder and proximal urethra which is dependent on surgical radicality. In contrast, incomplete bladder emptying after surgery for stress induced urinary incontinence, has its origin in an infravesicular functional obstruction and is dependent on the operation performed. The use of drugs (alpha-sympatholytics, parasympathomimetics) seem to be of limited value, especially after stress-incontinence surgery. Preoperative information, perioperative supra pubic bladder drainage, postoperative bladder training and in rare cases intermittent self-catheterisation and transurethral surgery are the key factors in successful treatment of postoperative urinary retention.

摘要

根治性子宫切除术后的尿潴留是由于膀胱和近端尿道部分或完全去神经支配,这取决于手术的根治程度。相比之下,压力性尿失禁手术后膀胱排空不完全,其根源在于膀胱下功能性梗阻,且取决于所进行的手术。药物(α-交感神经阻滞剂、拟副交感神经药)的使用似乎价值有限,尤其是在压力性尿失禁手术后。术前告知、围手术期耻骨上膀胱引流、术后膀胱训练以及在极少数情况下间歇性自我导尿和经尿道手术是成功治疗术后尿潴留的关键因素。

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