Petros Peter, Goeschen Klaus, Inoue Hiromi
University of Western Australia, Perth, Australia.
University of Hannover, Hannover, Germany.
Cent European J Urol. 2018;71(4):444-447. doi: 10.5173/ceju.2018.1793. Epub 2019 Nov 9.
The aim of this study was to compare the posterior fornix syndrome (PFS), (abnormal bladder emptying, urge, frequency, nocturia, chronic pelvic pain) cured/improved by uterosacral ligament (USL) ligation, with 'underactive bladder' (UAB) [2], whose cause and cure of UAB are said to be unknown [2].
A limited literature search was carried out for the words posterior fornix syndrome; obstructed micturition; post-void residual.
We found the diagnostic criteria used for UAB to be identical with PFS. Also, individual symptoms could be improved in the short term with squatting-based pelvic floor exercises, native tissue cardinal/uterosacral ligament repair, but requiring posterior ligament slings for a long term cure.
Because the similarity in symptoms may not be sufficient in the first instance to recommend surgery for UAB, we advise the use of a roll gauze or large tampon placed in the posterior fornix to support USLs ('simulated operation'), always with a full bladder, then observe any changes in PFS symptoms such as urge, pain, urine flow and post-void residual as a screening test before proceeding to surgery.
本研究旨在比较经子宫骶韧带（USL）结扎治愈/改善的后穹窿综合征（PFS，包括膀胱排空异常、尿急、尿频、夜尿症、慢性盆腔疼痛）与“膀胱功能减退”（UAB）[2]，据说UAB的病因及治疗方法尚不清楚[2]。
对后穹窿综合征、排尿困难、残余尿量等词汇进行了有限的文献检索。
我们发现用于UAB的诊断标准与PFS相同。此外，通过基于深蹲的盆底肌锻炼、天然组织主韧带/子宫骶韧带修复，个体症状可在短期内得到改善，但长期治愈需要后路韧带悬吊。
由于症状的相似性可能最初不足以推荐对UAB进行手术，我们建议在膀胱充盈时，在后穹窿放置一卷纱布或大棉球以支撑子宫骶韧带（“模拟手术”），然后观察PFS症状（如尿急、疼痛、尿流和残余尿量）的任何变化，作为手术前的筛查试验。
