Symmonds R E, Hill L M
Am J Obstet Gynecol. 1978 Jan 15;130(2):130-8. doi: 10.1016/0002-9378(78)90354-x.
A series of 50 patients presented with total urinary incontinence secondary to traumatic loss of much or all of the urethral floor and bladder neck. Previously, the 50 patients had been subjected to 94 unsuccessful operations; this serves to indicate the challenging nature of the problem. Surgical reconstruction was accomplished by creating a small-caliber neourethra from the contractile tissue that remained in the urethral roof. In addition, 22 of the 50 patients (44 per cent) required a supplemental myocutaneous labial skin flap (12 patients) or a bulbocavemosus muscle flap of the Martius type (10 patients). A "second-stage" retropubic urethrovesical suspension was required in 20 patients. After a follow-up period of five to 15 years, 37 of the 50 patients (74 per cent) were cured and an additional four patients (8 per cent) were greatly improved.
一系列50例患者因尿道盆底和膀胱颈大部分或全部外伤性缺失而出现完全性尿失禁。此前，这50例患者已经历了94次手术均未成功；这表明了该问题具有挑战性。通过利用尿道顶部残留的收缩组织构建小口径新尿道来完成手术重建。此外，50例患者中有22例（44%）需要补充肌皮阴唇皮瓣（12例患者）或马尔蒂厄斯型球海绵体肌瓣（10例患者）。20例患者需要进行“二期”耻骨后尿道膀胱悬吊术。经过5至15年的随访期，50例患者中有37例（74%）治愈，另有4例患者（8%）有显著改善。
