Sand P K, Bowen L W, Ostergard D R, Nakanishi A M
Women's Hospital, Memorial Medical Center of Long Beach.
J Reprod Med. 1988 Feb;33(2):171-4.
The effects of prior hysterectomy and incontinence surgery were evaluated retrospectively in 86 women undergoing modified Burch cystourethropexy. These women were evaluated before and three months after surgery with multichannel urodynamic testing. Forty percent of the 50 women with prior incontinence surgery remained incontinent after the cystourethropexy even though 94% of them had undergone anatomic correction. This result was not statistically different from the 28% failure rate in patients without prior incontinence surgery. Forty-two percent of the 62 women who had previously undergone hysterectomy failed cystourethropexy despite anatomic correction in 95%. This finding was significantly different from the 17% failure rate in women without prior hysterectomy (P less than .025). This retrospective analysis suggests that prior hysterectomy may place women at increased risk of continued incontinence following cystourethropexy despite anatomic correction of urethrovesical junction descent. Contrary to the results of other investigators, women with prior incontinence surgery in this study were not found to be at significantly greater risk of incontinence after cystourethropexy.
对86例行改良Burch膀胱尿道悬吊术的女性患者，回顾性评估既往子宫切除术和尿失禁手术的影响。这些女性在手术前和术后三个月接受多通道尿动力学检测。50例既往有尿失禁手术史的女性中，40%在膀胱尿道悬吊术后仍存在尿失禁，尽管其中94%的患者已进行了解剖学矫正。这一结果与既往无尿失禁手术史患者28%的失败率相比，无统计学差异。62例既往有子宫切除术史的女性中，42%的膀胱尿道悬吊术失败，尽管95%的患者已进行了解剖学矫正。这一发现与既往无子宫切除术史女性17%的失败率相比，有显著差异（P<0.025）。这项回顾性分析表明，尽管尿道膀胱连接部下移已进行了解剖学矫正，但既往子宫切除术可能会使女性在膀胱尿道悬吊术后持续尿失禁的风险增加。与其他研究者的结果相反，本研究中既往有尿失禁手术史的女性在膀胱尿道悬吊术后并未发现尿失禁风险显著增加。
