Errando C, Batista J E, Araño P
Department of Urology, Fundacion Puigvert, Barcelona, Spain.
World J Urol. 1996;14 Suppl 1:S48-50. doi: 10.1007/BF00182065.
Surgery for stress urinary incontinence (SUI) in women with previous interventions is often difficult and yields poor results. A total of 33 women with recurrent SUI underwent placement of a polytetrafluoroethylene (PTFE) sling after a mean of 1.5 (range, 1-3) unsuccessful operations. Preoperative bladder instability (BI) was ruled out in all cases. The patients' mean age was 54 (range, 34-79) years. In all, 64% had SUI and 36% had SUI and incontinence at rest. The Aldrige-Stoeckel technique is used with insertion of a 2 x 30 cm sling instead of fascia lata. Mean operating time was reduced in 40 minutes. After a mean follow-up period of 13 months, 72% of the patients achieved continence without retention (complete success). Altogether, 16 patients (48%) required self-catheterization after discharge, with the voiding imbalance lasting for more than 3 months in only 4 cases (12% of the total). Three patients underwent surgery for outlet obstruction. There were five abdominal wound infections but no vaginal wound infection. Two slings have since been removed (one partially), but none has eroded through the urethra. The PTFE sling is a reasonable option for this group of patients. Retention is usually self-limited, and most complications can be managed successfully.
对于曾接受过干预治疗的女性压力性尿失禁（SUI）患者，手术往往难度较大且效果不佳。共有33例复发性SUI女性患者在平均1.5次（范围1 - 3次）手术失败后接受了聚四氟乙烯（PTFE）吊带置入术。所有病例术前均排除膀胱不稳定（BI）。患者平均年龄为54岁（范围34 - 79岁）。其中，64%的患者存在SUI，36%的患者存在SUI且静息时失禁。采用Aldrige - Stoeckel技术，置入一条2×30 cm的吊带而非阔筋膜。平均手术时间减少了40分钟。平均随访13个月后，72%的患者实现了控尿且无尿潴留（完全成功）。总共16例患者（48%）出院后需要自行导尿，只有4例（占总数的12%）排尿失衡持续超过3个月。3例患者因出口梗阻接受了手术。发生了5例腹部伤口感染，但无阴道伤口感染。此后有2条吊带被取出（1条部分取出），但无一例通过尿道侵蚀。PTFE吊带对于这类患者是一种合理的选择。尿潴留通常是自限性的，大多数并发症可以成功处理。
