Holm J, Struckmann J R, Frimodt-Møller C
Kirurgisk afdeling H., Amtssygehuset i Gentofte.
Ugeskr Laeger. 1995 Mar 13;157(11):1528-30.
The results after "clam"-augmentation cystoplasty are assessed in 11 consecutively operated women aged 35-78. All were suffering from severe urgency. Eight were urge-incontinent and six of these stress-incontinent as well. Nine patients had been operated before with a total of 14 operations. Bladder distension and parasympatholytic medication had been tried in two and seven instances respectively. One patient died of a pulmonary embolism three weeks postoperatively. Follow-up ranged from 12-52 months, mean 29 months. Eight (80% (44-97)%) of the remaining 10 patients were cured with respect to urgency. One patient was improved, and one unchanged. Three (60% (15-95)%) out of five previously stress-incontinent patients were dry, one was improved and one unchanged in spite of a subsequent stamey urethrosuspension. Eight patients (80% (44-97)%) had spontaneous micturition, one used self-catheterisation once daily and one patient was retained on an indwelling catheter. It is concluded that augmentation cystoplasty is a procedure of considerable value in patients with disabling non-neurogenic urgency, where conservative therapy and previous surgery has failed.
对11例年龄在35至78岁之间连续接受手术的女性进行了“蛤壳”式膀胱扩大成形术后结果评估。所有患者均有严重尿急症状。其中8例有急迫性尿失禁,其中6例同时伴有压力性尿失禁。9例患者曾接受过手术,共进行了14次手术。分别有2例和7例尝试过膀胱扩张和使用抗副交感神经药物治疗。1例患者术后3周死于肺栓塞。随访时间为12至52个月,平均29个月。其余10例患者中有8例(80%(44 - 97)%)尿急症状治愈。1例患者症状改善,1例无变化。5例既往有压力性尿失禁的患者中,3例(60%(15 - 95)%)不再漏尿,1例改善,1例尽管随后接受了史坦利尿道悬吊术但症状无变化。8例患者(80%(44 - 97)%)能自主排尿,1例每天自行导尿1次,1例患者留置导尿管。结论是,对于保守治疗和既往手术失败的致残性非神经源性尿急患者,膀胱扩大成形术是一种具有重要价值的手术。