Hoffman M S, Arango H
Department of Obstetrics and Gynecology, Tampa General Hospital, University of South Florida College of Medicine 33606, USA.
J Reprod Med. 1995 Mar;40(3):181-4.
A pilot study was conducted assessing the operative feasibility, complications and results of a retropubic bladder neck suspension performed through a transvestibular approach. This study extended from July 1, 1990, to June 30, 1991, and included patients who planned to undergo primary surgical correction of stress urinary incontinence. Through a transvestibular incision, a bladder neck suspension was performed by suturing the adjacent area of the vagina to the back of the pubic symphysis or the puborectalis muscle near the pubic bone. Ten women were entered into the study. There was one notable complication, a hematoma in the space of Retzius. One patient described worsening of her incontinence and underwent a Marshall-Marchetti-Krantz procedure three months postoperatively. The mean follow-up for the remaining nine patients was 27 months (range, 13-31). At this writing, 6 patients were completely continent, 1 was improved, and 2 had some degree of bladder instability with associated incontinence. Overall, the transvestibular procedure was thought to be technically difficult. Based on very limited data, the results of the study have discouraged our continued use of this procedure. The transvestibular approach may be applicable occasionally on selected patients.
开展了一项初步研究，评估经前庭入路耻骨后膀胱颈悬吊术的手术可行性、并发症及效果。该研究从1990年7月1日持续至1991年6月30日，纳入了计划接受压力性尿失禁一期手术矫正的患者。通过前庭切口，将阴道相邻区域缝合至耻骨联合后方或耻骨附近的耻骨直肠肌，进行膀胱颈悬吊术。10名女性纳入该研究。出现了1例明显并发症，即耻骨后间隙血肿。1例患者自述尿失禁加重，术后3个月接受了Marshall-Marchetti-Krantz手术。其余9例患者的平均随访时间为27个月（范围13 - 31个月）。撰写本文时，6例患者完全控尿，1例改善，2例有一定程度的膀胱不稳定伴尿失禁。总体而言，经前庭手术在技术上被认为有难度。基于非常有限的数据，该研究结果不鼓励我们继续使用此手术方法。经前庭入路可能偶尔适用于特定患者。
