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[韦特海姆手术后的膀胱并发症——关于在可比条件下进行对照随访的建议(作者译)]

[Urinary bladder complications following Wertheim operations--recommendations for a controlled follow-up with comparable conditions (author's transl)].

作者信息

Christ F, Wagner U, Behr J

出版信息

Geburtshilfe Frauenheilkd. 1981 Nov;41(11):754-8. doi: 10.1055/s-2008-1036984.

Abstract

At defined times prior and following a Wertheim operation for cancer of the uterine cervix the patients were investigated for the functional parameters of the lower urinary tract. The residual urine was determined. Stress incontinence and urgency incontinence were measured with urethrocystometry. The sensitivity and the micturition were evaluated from subjective data. The results of 237 investigations in 192 operated women are described and compared to previous papers on the subject. Stress incontinence increased to double the pre-operative incidence following the Wertheim operation. An urgency incontinence was quite rare. A lack of feeling of fullness to the bladder as a sign of disturbed bladder sensitivity was present 5 months post-operatively in 6 of 45 patients (13%). This was present in only 1 of 119 patients (1%) after five years. 1/3 of the women had difficulty with spontaneous micturition five months following the operation. 1/10 of the women had difficulty with spontaneous micturition 5 years after the operation. There was no residual urine five months after the operation in 9/10 of the patients and five years following the operation almost 100% of the patients had no residual urine. It was noted that difficulty with spontaneous micturition with residual urine and urgency incontinence did not necessarily result in concomitant bacteriuria. Suggestions are presented how future investigations with similar questions may lead to comparable results.

摘要

在对子宫颈癌进行韦特海姆手术前后的特定时间,对患者的下尿路功能参数进行了研究。测定了残余尿量。通过尿道膀胱测压法测量压力性尿失禁和急迫性尿失禁。根据主观数据评估敏感性和排尿情况。描述了192例接受手术的女性的237次检查结果,并与之前关于该主题的论文进行了比较。韦特海姆手术后,压力性尿失禁增加到术前发病率的两倍。急迫性尿失禁相当罕见。45例患者中有6例(13%)在术后5个月出现膀胱充盈感缺失,这是膀胱敏感性受损的迹象。5年后,119例患者中只有1例(1%)出现这种情况。1/3的女性在术后5个月出现自主排尿困难。1/10的女性在术后5年出现自主排尿困难。9/10的患者在术后5个月没有残余尿,术后5年几乎100%的患者没有残余尿。值得注意的是,伴有残余尿的自主排尿困难和急迫性尿失禁不一定会导致并发细菌尿。文中提出了一些建议,说明未来针对类似问题的研究如何能得出可比的结果。

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