Schaeffer A J
Clin Obstet Gynecol. 1984 Jun;27(2):459-73. doi: 10.1097/00003081-198406000-00021.
This method of elevating the vesical neck with two permanent nylon sutures is effective for correcting primary or recurrent stress urinary incontinence and even total urinary incontinence in over 90% of patients. The cystoscope guides placement of the nylon sutures, and the buttress supports the tissues to achieve precise functional closure of the bladder neck. The technique causes less blood loss and postoperative morbidity than many other operations because open pelvic surgery is avoided. There is less pain, and the patient can be discharged with supra-public urinary drainage on the second or third postoperative day if desirable. The procedure can be performed easily by a single surgeon in less than an hour in uncomplicated patients and is no more difficult in obese women than in thin women. It is particularly well adapted for patients who have failed other procedures for stress urinary incontinence and those with previous pelvic fracture, pelvic irradiation, or trauma. Simultaneous repair of significant rectoceles or substantial cystoceles can be performed through the same operative field, and hysterectomy is not required for achievement of adequate endoscopic suspension of the bladder neck.
这种用两根永久性尼龙缝线抬高膀胱颈的方法，对纠正原发性或复发性压力性尿失禁，甚至对超过90%的患者的完全性尿失禁都有效。膀胱镜引导尼龙缝线的放置，支撑物支撑组织以实现膀胱颈的精确功能性闭合。与许多其他手术相比，该技术导致的失血量和术后发病率更低，因为避免了开放性盆腔手术。疼痛较轻，如果需要，患者可在术后第二天或第三天带耻骨上导尿管出院。在无并发症的患者中，该手术可由一名外科医生在不到一小时内轻松完成，肥胖女性进行该手术并不比瘦女性困难。它特别适合于其他压力性尿失禁治疗方法失败的患者以及既往有骨盆骨折、盆腔放疗或创伤的患者。通过相同的手术视野可同时修复明显的直肠膨出或较大的膀胱膨出，且实现膀胱颈充分的内镜下悬吊不需要进行子宫切除术。
