Narushima M, Kondo A
Department of Urology, Chubu Rosai Hospital.
Nihon Hinyokika Gakkai Zasshi. 1995 May;86(5):1051-9. doi: 10.5980/jpnjurol1989.86.1051.
We have investigated surgical results of quantitative suspension of the bladder neck for stress urinary incontinence. Three hundred ninety-four female patients suffering from stress incontinence have been operated on with Stamey's or Gittes' procedures during the past 8 years. While the bladder neck was elevated by quantifying tension of nylon threads in 84 patients, 310 patients subsequently were operated on by quantifying both tension and length of nylon loops. A follow-up period averaged 51 months for a group of the Stamey's and 19 months for a group of Gittes' procedures. Postoperative continence rate was defined by patients' subjective evaluation. Those whose nylon loops were quantified as from 130 to 149 mm attained the highest continence rate, which was not related to age or severity of incontinence. Postoperative difficulty in urination was less in those who had nylon loops of 130 to 149 mm, and was more in those over 60 years of age. Eighty-eight percent of the patients stated very much satisfied or satisfied with the surgery they had undergone. Continence rate was 78% for those operated on with the Stamey's (51 months later) and 69% with the Gittes' procedures (19 months later). The 7-year continence rate was 77% for the former and the 3-year continence rate was 38% for the latter, indicating that the Stamey's procedure was significantly more useful than the Gittes' procedure. Postoperative complications were encountered with 17% of the patients. We conclude that quantitative suspension of the bladder neck is of value to obtain the high success rate of the needle suspension procedure.
我们研究了膀胱颈定量悬吊术治疗压力性尿失禁的手术效果。在过去8年中，394例患有压力性尿失禁的女性患者接受了Stamey手术或Gittes手术。其中84例患者通过量化尼龙线的张力来抬高膀胱颈，随后310例患者通过量化尼龙圈的张力和长度进行手术。一组Stamey手术患者的平均随访期为51个月，一组Gittes手术患者的平均随访期为19个月。术后控尿率由患者主观评估确定。尼龙圈长度量化为130至149毫米的患者控尿率最高，且该控尿率与年龄或尿失禁严重程度无关。尼龙圈长度为130至149毫米的患者术后排尿困难较少，60岁以上患者排尿困难较多。88%的患者对其所接受的手术表示非常满意或满意。Stamey手术患者术后51个月的控尿率为78%，Gittes手术患者术后19个月的控尿率为69%。前者的7年控尿率为77%，后者的3年控尿率为38%，这表明Stamey手术比Gittes手术明显更有效。17%的患者出现了术后并发症。我们得出结论，膀胱颈定量悬吊术对于提高针式悬吊术的成功率具有重要价值。
