Hampel C, Baunacke M
Fachklinik für Urologie, Standort Erwitte, Klinikum Lippstadt gGmbH, Akademisches Lehrkrankenhaus, Westfälische Wilhelms-Universität Münster, Von-Droste-Straße 14, 59597, Erwitte, Deutschland.
Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Urologie. 2025 May 12. doi: 10.1007/s00120-025-02581-x.
Reconstructive pelvic floor surgery offers a wide range of surgical options for treating urinary incontinence, organ prolapse and other pelvic floor disorders. The aim is always to choose the safest and most effective procedure to improve the quality of life of those affected. In addition to expertise in making the appropriate diagnosis and surgical experience, knowledge of how to deal with complications is always essential. When categorising complications, a distinction is made between early and late complications, intraoperative and postoperative complications, and general and procedure-specific complications. If complications arise, conservative and surgical treatment options should be known. The starting point here is adequate diagnostics, which may include basic examinations, sonography, endoscopy and imaging techniques. The aim is to be able to accurately assess the extent of the complication in order to choose the appropriate therapy-preferably conservative methods. Particular challenges in the management of complications in reconstructive pelvic floor surgery are posed by complications with foreign materials. Surgical complication management can be very complex, requires a high level of surgical expertise and may also require an interdisciplinary approach. Gaining expertise in managing complications, whether conservative or surgical methods, can be challenging, especially when aiming to avoid causing those complications yourself. Thus, the best complication management is preventive: knowing the patient well, diagnosing the disease precisely and knowing one's own limits!
盆底重建手术为治疗尿失禁、器官脱垂及其他盆底疾病提供了广泛的手术选择。其目标始终是选择最安全、最有效的手术方式来改善患者的生活质量。除了具备做出恰当诊断的专业知识和手术经验外，了解如何处理并发症也至关重要。在对并发症进行分类时，可分为早期和晚期并发症、术中及术后并发症，以及一般并发症和特定手术并发症。如果出现并发症，应了解保守治疗和手术治疗方案。在此，充分的诊断是起点，这可能包括基础检查、超声检查、内镜检查和成像技术。目的是能够准确评估并发症的程度，以便选择合适的治疗方法——最好是保守方法。异物相关并发症给盆底重建手术的并发症管理带来了特殊挑战。手术并发症的管理可能非常复杂，需要高水平的手术专业知识，还可能需要多学科方法。无论是通过保守还是手术方法来掌握并发症管理的专业知识都具有挑战性，尤其是当旨在避免自己引发这些并发症时。因此，最佳的并发症管理是预防性的：充分了解患者、精确诊断疾病并清楚自身的局限！
