Grabbert M, Bauer R M
Klinik für Urologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Deutschland.
Klinik und Poliklinik für Urologie, LMU Klinikum, Campus Großhadern, München, Deutschland.
Urologe A. 2021 Jun;60(6):706-713. doi: 10.1007/s00120-021-01530-8. Epub 2021 May 3.
Surgery for urinary incontinence is indicated after failure of conservative treatment with pelvic floor therapy. Different sling systems are the established treatment option for urinary incontinence for female and male patients. Tension-free vaginal tapes represent the standard of care in the surgical treatment of female stress urinary incontinence. In male patients with mild or moderate stress urinary incontinence, fixed repositioning slings or adjustable compressive slings represent minimally invasive alternatives to the artificial urinary sphincter. The use of surgical mesh material has been widely discussed within the last years. The current US Food and Drug Administration warning was focused on the use of transvaginal mesh implants in female patients with pelvic organ prolapse. Within the current debate, surgery for stress urinary incontinence and surgery for pelvic organ prolapse have often not been differentiated. With this ongoing discussion about the use of foreign material in reconstructive surgery, laparoscopic colposuspension might be performed more often in the near future.
在盆底治疗保守治疗失败后，可考虑进行尿失禁手术。不同的吊带系统是女性和男性尿失禁的既定治疗选择。无张力阴道吊带是女性压力性尿失禁手术治疗的护理标准。对于轻度或中度压力性尿失禁的男性患者，固定重新定位吊带或可调节压迫吊带是人工尿道括约肌的微创替代方案。在过去几年中，外科网片材料的使用受到了广泛讨论。美国食品药品监督管理局目前的警告主要集中在盆腔器官脱垂女性患者中经阴道网片植入物的使用。在当前的辩论中，压力性尿失禁手术和盆腔器官脱垂手术常常没有区分开来。随着关于重建手术中使用异体材料的讨论不断进行，腹腔镜阴道悬吊术在不久的将来可能会更频繁地进行。
