Colombo M, Scalambrino S, Maggioni A, Milani R
Department of Obstetrics and Gynecology, University of Milan, San Gerardo Hospital.
Am J Obstet Gynecol. 1994 Dec;171(6):1573-9. doi: 10.1016/0002-9378(94)90404-9.
Our purpose was to compare the effects of the Burch colposuspension with those of the modified Marshall-Marchetti-Krantz urethropexy.
Eighty women underwent the two types of operation. A full urodynamic investigation was repeated 6 months after surgery.
Clinical follow-up continued for 2 to 7 years. Differences in subjective and objective cure rates were not statistically significant (respectively, 92% and 80% for the Burch colposuspension and 85 and 65% for the modified Marshall-Marchetti-Krantz urethropexy). The latter induced a longer hospital stay (7.4 vs 6.3 days, p = 0.001), a later resumption of spontaneous voiding (13.8 vs 8.5 days, p = 0.002), and was associated with considerable complications (one case of blood replacement for retropubic hematoma, one case of severe voiding difficulty, one case of further treatment for stress incontinence, and three cases of symptomatic de novo detrusor instability).
For its high cure rate, short time to resumption of spontaneous voiding, short hospital stay, and low associated morbidity, the Burch colposuspension should remain the procedure of choice for stress incontinence.
我们的目的是比较Burch阴道悬吊术与改良Marshall-Marchetti-Krantz尿道悬吊术的效果。
80名女性接受了这两种手术。术后6个月重复进行全面的尿动力学检查。
临床随访持续2至7年。主观和客观治愈率的差异无统计学意义（Burch阴道悬吊术分别为92%和80%，改良Marshall-Marchetti-Krantz尿道悬吊术分别为85%和65%）。改良Marshall-Marchetti-Krantz尿道悬吊术导致住院时间更长（7.4天对6.3天，p = 0.001），自主排尿恢复时间更晚（13.8天对8.5天，p = 0.002），并且伴有相当多的并发症（1例因耻骨后血肿进行输血，1例严重排尿困难，1例因压力性尿失禁进一步治疗，3例出现症状性新发逼尿肌不稳定）。
由于Burch阴道悬吊术治愈率高、自主排尿恢复时间短、住院时间短且相关发病率低，它应仍然是压力性尿失禁的首选手术方法。
