Gormley E A, Bloom D A, McGuire E J, Ritchey M L
Department of Surgery, University of Michigan, Ann Arbor.
J Urol. 1994 Aug;152(2 Pt 2):822-5; discussion 826-7. doi: 10.1016/s0022-5347(17)32720-9.
A pubovaginal sling is an effective treatment for type III incontinence secondary to poor proximal urethral sphincter function. We used a pubovaginal sling to treat incontinence in 15 female adolescents. The etiology of incontinence was spinal dysraphism in 10 patients and prior trauma in 3. Simultaneous bladder augmentation was performed in the remaining 2 patients for poor bladder compliance. Three patients required additional procedures including repeat slings in 2 and repeat augmentation in 1. Of 13 patients followed for more than 6 months 11 remain dry, 1 leaks small amounts and wears 1 pad per day, and 1 did not achieve acceptable continence and was subsequently managed with bladder augmentation and a Mitrofanoff procedure. The upper urinary tracts have remained normal in all 13 patients. The pubovaginal sling has proved to be safe and successful in these children. The overall continence rate of 92% compares favorably to other available modalities.
耻骨后阴道吊带术是治疗因近端尿道括约肌功能不佳导致的Ⅲ型尿失禁的有效方法。我们采用耻骨后阴道吊带术治疗了15例女性青少年尿失禁患者。尿失禁的病因包括10例脊髓脊膜膨出和3例既往创伤。其余2例因膀胱顺应性差同时进行了膀胱扩大术。3例患者需要额外的手术，其中2例重复吊带术，1例重复膀胱扩大术。在13例随访超过6个月的患者中，11例保持干爽，1例少量漏尿，每天使用1片尿垫，1例未达到可接受的控尿效果，随后接受了膀胱扩大术和米氏手术。所有13例患者的上尿路均保持正常。耻骨后阴道吊带术在这些儿童中已证明是安全且成功的。92%的总体控尿率与其他可用方法相比具有优势。
