Awad S A, Flood H D, Acker K L
Department of Urology, Victoria General Hospital, Halifax, Nova Scotia, Canada.
J Urol. 1988 Sep;140(3):514-7. doi: 10.1016/s0022-5347(17)41706-x.
In a series of 148 consecutive female patients with urinary incontinence 62 (group 1) had undergone 1 or more prior anti-incontinence operations and 86 (group 2) had none. After clinical and urodynamic assessment the incidence of detrusor instability in the 2 groups (44 and 51 per cent) was not significantly different but the incidence of stress incontinence in group 1 was significantly greater than in group 2 (58 and 38 per cent, p less than 0.05). Of the 69 patients with a final diagnosis of stress urinary incontinence 45 (24 in group 1) had surgery and were followed for a mean of 17 months postoperatively. Of the patients 43 (95 per cent) were cured or improved. A total of 17 patients (71 per cent) in group 1 and 3 (17 per cent) in group 2 had a fascial sling. Eight patients had symptomatic postoperative detrusor instability and all had a fascial sling. There also was a significant decrease in postoperative peak flow rate (p less than 0.01) in these patients. Neither the number of previous operations nor the presence of preoperative detrusor instability had a significant effect on the incidence of postoperative detrusor instability.
在连续的148例女性尿失禁患者中，62例（第1组）曾接受过1次或多次抗尿失禁手术，86例（第2组）未接受过此类手术。经过临床和尿动力学评估，两组逼尿肌不稳定的发生率（分别为44%和51%）无显著差异，但第1组压力性尿失禁的发生率显著高于第2组（分别为58%和38%，p<0.05）。在最终诊断为压力性尿失禁的69例患者中，45例（第1组24例）接受了手术，并在术后平均随访17个月。其中43例（95%）患者治愈或症状改善。第1组共有17例患者（71%）和第2组3例患者（17%）使用了筋膜吊带。8例患者术后出现有症状的逼尿肌不稳定，均使用了筋膜吊带。这些患者术后的最大尿流率也显著降低（p<0.01）。既往手术次数和术前逼尿肌不稳定的存在对术后逼尿肌不稳定的发生率均无显著影响。
