Iris de la Cruz S, Ramírez Melgar E, Senties Cortina L
Hospital Ginecoobstétrico Luis Castelazo Ayala, IMSS, México, D.F.
Ginecol Obstet Mex. 1994 Oct;62:287-91.
All successful operations for relief of genuine stress urinary incontinence (SUI) have three objectives: elevation and retropubic maintenance during stress of the urethrovesical junction. The present study was realized at the Urogynecologic Service of the "Luis Castelazo Ayala" hospital IMSS to evaluate the results in a two years follow up of 597 patients that suffered from SUI treated by retropubic urethropexy, from February 1984 to May 1991. Patients were studied according to the service norms, previously published. We realized four types of procedures: Pereyra (379 cases), Burch (90 cases), Marchall-Marchetti-Kratz (60 cases) and Powell surgery (68 cases). Vaginal approach was realized in cases of pelvigenital statics disturbances like cysto- or rectocele; and abdominal approach was indicated in patients with enlarged uterus or pelvic masses. The complications rate was 15.3%. Success rate was 87.06% for all procedures and not statistic significance was found (p > or = 0.1 and X2 = 6.15), the best rate to the Burch and Pereyra procedures. We conclude the most important tip to successful rate in SUI surgery is correct choice of the procedure according to the patient.
所有成功缓解真性压力性尿失禁（SUI）的手术都有三个目标：在压力状态下抬高并耻骨后固定尿道膀胱连接部。本研究在墨西哥社会保障局（IMSS）“路易斯·卡斯特拉佐·阿亚拉”医院的妇科泌尿服务部开展，以评估1984年2月至1991年5月间597例接受耻骨后尿道固定术治疗的SUI患者在两年随访中的结果。患者按照先前发表的服务规范进行研究。我们实施了四种手术方式：佩雷拉手术（379例）、伯奇手术（90例）、马歇尔 - 马凯蒂 - 克拉茨手术（60例）和鲍威尔手术（68例）。对于存在盆腔生殖器静力性紊乱如膀胱膨出或直肠膨出的病例采用经阴道入路；对于子宫增大或盆腔肿物的患者采用经腹入路。并发症发生率为15.3%。所有手术方式的成功率为87.06%，未发现统计学差异（p≥0.1且X² = 6.15），伯奇手术和佩雷拉手术的成功率最高。我们得出结论，SUI手术成功率的最重要关键在于根据患者情况正确选择手术方式。
