Santarosa R P, Blaivas J G
Squire Urologic Clinic, Columbia-Presbyterian Medical Center, New York, New York.
J Urol. 1994 Mar;151(3):607-11. doi: 10.1016/s0022-5347(17)35029-2.
A total of 15 women with stress incontinence and 6 men with post-prostatectomy sphincteric incontinence underwent periurethral injection of autologous fat while under local anesthesia. The fat was harvested from the abdominal wall by liposuction. Preoperative evaluation consisted of a micturition diary, questionnaire, semiquantitative pad test, cystoscopy and urodynamics. Sequential injections were performed at 1 to 3-month intervals. Results were assessed by subjective patient scores, pad tests and clinical evaluation performed at intervals. Followup was 12 to 30 months (mean 18). Only 1 man and none of the women with urethral hypermobility had lasting improvement. Of the 15 women 12 had intrinsic sphincteric deficiency (type 3 stress incontinence) and they were our most successful group. Of the 12 women 10 (83%) were improved (mean score of 8.8-7 before injection compared to 1.87 after injection) at 1 month following the initial injection. Of the 9 patients who continued with the treatment 7 (78%) noticed lasting improvement objectively and subjectively after 1 to 4 injections (mean 2.4). We believe that this technique shows sufficient promise as an alternative therapy for sphincteric incontinence to warrant continued clinical investigation.
15名压力性尿失禁女性患者和6名前列腺切除术后括约肌性尿失禁男性患者在局部麻醉下接受了尿道周围自体脂肪注射。脂肪通过吸脂术从腹壁获取。术前评估包括排尿日记、问卷调查、半定量尿垫试验、膀胱镜检查和尿动力学检查。每隔1至3个月进行一次序贯注射。通过患者主观评分、尿垫试验以及定期进行的临床评估来评估结果。随访时间为12至30个月（平均18个月）。只有1名男性以及尿道活动过度的女性患者均未获得持久改善。15名女性患者中有12名存在固有括约肌缺陷（3型压力性尿失禁），她们是最成功的一组。12名女性患者中，10名（83%）在首次注射后1个月时病情得到改善（注射前平均评分为8.8 - 7分，注射后为1.87分）。9名继续接受治疗的患者中，7名（78%）在1至4次注射（平均2.4次）后在客观和主观上均有持久改善。我们认为，作为括约肌性尿失禁的一种替代疗法，该技术显示出了足够的前景，值得继续进行临床研究。
