Morgan J E, Heritz D M, Stewart F E, Connolly J C, Farrow G A
Department of Surgery, University of Toronto, Ontario, Canada.
J Urol. 1995 Sep;154(3):1013-4; discussion 1015-6.
The significance of a 2-team approach to the problems of recurrent incontinence in patients with extensive pelvic scarring from previous surgery is emphasized.
We reviewed 88 consecutive patients who presented between January 1986 and November 1992. The demonstration of a scarred, wide open, proximal urethra or drain pipe urethra was the important selection criterion. Two teams, 1 operating abdominally and 1 vaginally, released the bladder neck from its bed of scar under direct vision and set the sling in place with minimal tension at the bladder neck.
Of the women 75 (85.2%) were cured of the stress urinary incontinence and 8 (9.1%) had improvement with mainly urge incontinence, while 5 (5.7%) operations failed. There was a significant association between chronic chest disease and failure.
The 2-team polypropylene (Marlex) mesh approach continues to be an effective treatment for women with complicated stress urinary incontinence.
强调采用双团队方法处理既往手术导致广泛盆腔瘢痕的患者复发性尿失禁问题的重要性。
我们回顾了1986年1月至1992年11月间连续就诊的88例患者。重要的入选标准是近端尿道瘢痕化、开放且宽大或呈引流管样尿道。两个团队，一个经腹部手术，一个经阴道手术，在直视下将膀胱颈从瘢痕床中游离出来，并在膀胱颈处以最小张力放置吊带。
75名（85.2%）女性的压力性尿失禁得到治愈，8名（9.1%）主要表现为急迫性尿失禁的患者有所改善，而5名（5.7%）手术失败。慢性胸部疾病与手术失败之间存在显著关联。
双团队聚丙烯（Marlex）网片法仍是治疗复杂压力性尿失禁女性的有效方法。
