Freedman E R, Singh G, Donnell S C, Rickwood A M, Thomas D G
Regional Department of Paediatric Urology, Royal Liverpool Children's Hospital Alder Hey, UK.
Br J Urol. 1994 Jun;73(6):621-4. doi: 10.1111/j.1464-410x.1994.tb07545.x.
To perform bladder neck suspension simultaneously with augmentation cystoplasty in female patients where sphincteric incompetence was not the sole cause of impaired functional bladder capacity.
During an 8-year-period, 26 female patients (mean age 14, range 5-39) were treated with a Marshall-Marchetti plus cystoplasty (Liverpool) or a colposuspension plus clam cystoplasty (Sheffield). All had marked sphincteric incompetence compounded by detrusor hyper-reflexia and/or non-compliance. The patients were followed up for a mean period of 30 months (range 8-80).
There were no major complications. At follow-up 23 (88%) were dry by day on a regime of intermittent self-catheterization. Nine patients were taking adjuvant medication, usually for prevention of nocturnal enuresis.
The results compare tolerably with those of all alternative procedures, including the more elaborate reconstructions (e.g. Kropp procedure) and the expensive artificial urinary sphincter.
在功能性膀胱容量受损并非仅由括约肌功能不全引起的女性患者中，同时进行膀胱颈悬吊术和膀胱扩大术。
在8年期间，26例女性患者（平均年龄14岁，范围5 - 39岁）接受了马歇尔 - 马凯蒂联合膀胱扩大术（利物浦术式）或阴道悬吊联合蛤壳式膀胱扩大术（谢菲尔德术式）治疗。所有患者均存在明显的括约肌功能不全，并伴有逼尿肌反射亢进和/或顺应性降低。患者平均随访30个月（范围8 - 80个月）。
无重大并发症。随访时，23例（88%）患者在间歇性自我导尿方案下白天无尿失禁。9例患者正在服用辅助药物，通常用于预防夜间遗尿。
与所有其他替代手术的结果相比，包括更复杂的重建手术（如克罗普手术）和昂贵的人工尿道括约肌，本研究结果尚可接受。
