Stöcklin M W, Alder C G
Geburtshilfe Frauenheilkd. 1986 Aug;46(8):524-9. doi: 10.1055/s-2008-1036249.
236 patients were reevaluated one year after vaginal or suprapubic continence surgery. Personal history, clinico-gynaecological status, morphology and urodynamics were considered. 70.6% respectively 82% of all patients considered themselves cured. These numbers correlate well with objective control parameters. The clinical examination shows that a suprapubic approach is better for an urethrocele whereas vaginal surgery is more successful for a cystocele or rectocele. The correction of an urethrocele has however a greater influence on the chance of cure. Obesity is a risk factor especially for vaginal surgery and in both groups oestrogen application improved the healing process. The morphological examination demonstrates the importance of urethro-vesical suspension giving better results after suprapubic than after vaginal operation. The urodynamic results depend on the choice of measurement parameters. Suprapubic surgery generally brings about a greater improvement in pressure conditions than vaginal surgery. The best parameter seems to be the Dep Q. Vaginal continence surgery needs a good indication with a best possible urethro-vesical suspension. This is not an operation for beginners.
236例患者在接受阴道或耻骨上节制手术一年后接受了重新评估。考虑了个人病史、临床妇科状况、形态学和尿动力学。分别有70.6%和82%的患者认为自己已治愈。这些数字与客观控制参数相关性良好。临床检查表明，耻骨上入路对于尿道膨出效果更好，而阴道手术对于膀胱膨出或直肠膨出更为成功。然而，尿道膨出的矫正对治愈几率有更大影响。肥胖是一个危险因素，尤其是对于阴道手术，并且在两组中雌激素的应用都改善了愈合过程。形态学检查表明尿道膀胱悬吊术的重要性，耻骨上手术后的效果优于阴道手术后。尿动力学结果取决于测量参数的选择。耻骨上手术通常比阴道手术在压力状况方面带来更大改善。最佳参数似乎是Dep Q。阴道节制手术需要有良好的适应证，并尽可能进行最佳的尿道膀胱悬吊。这不是初学者能做的手术。
