Athanassopoulos A, Barbalias G
Department of Urology, School of Medicine, University of Patras, Greece.
Urol Int. 1996;56(1):23-7. doi: 10.1159/000282803.
A total of 51 consecutive female patients with genuine stress incontinence who underwent a Burch or Stamey operation were clinically and urodynamically evaluated preoperatively at least 8 months postoperatively. Our study group consisted of 27 women who underwent the Burch colposuspension and 24 who had the Stamey endoscopic bladder neck suspension. The urodynamic parameters which were studied pre- and postoperatively were the maximum flow rate (Qmax), the residual urine (Vres), the first sensation (FS), the bladder capacity (BC), the maximum vesical pressure (Pves max), the detrusor pressure at maximum flow (Pdet/Qmax), the functional urethral length (Lfun) and the maximum closure pressure (Pclos max). The successful results of the operations were 89% for Burch and 83% for the Stamey procedure. As for differing objective urodynamic findings, the Qmax, Pclos max, Vres and Lfun for both groups were the only parameters which showed statistically significant difference after surgery. The statistical comparison of the postoperative urodynamic parameters of the two operative techniques showed that Lfun, Pves max and Pclos max had difference in favor of Burch colposuspension. There were not statistical differences in the other studied parameters. In conclusion, according to the differentiation in the values of Pclos max, Lfun and Pves max, the Burch technique seems to result in a higher increase of patient's urethral resistance.
共有51例连续性真性压力性尿失禁女性患者接受了Burch手术或Stamey手术,并在术后至少8个月时进行了临床和尿动力学评估。我们的研究组包括27例行Burch阴道旁修补术的女性和24例行Stamey内镜下膀胱颈悬吊术的女性。术前和术后研究的尿动力学参数包括最大尿流率(Qmax)、残余尿量(Vres)、首次感觉(FS)、膀胱容量(BC)、最大膀胱压力(Pves max)、最大尿流率时逼尿肌压力(Pdet/Qmax)、功能性尿道长度(Lfun)和最大闭合压力(Pclos max)。Burch手术的成功率为89%,Stamey手术的成功率为83%。至于不同的客观尿动力学结果,两组的Qmax、Pclos max、Vres和Lfun是术后仅有的显示出统计学显著差异的参数。两种手术技术术后尿动力学参数的统计学比较显示,Lfun、Pves max和Pclos max存在差异,有利于Burch阴道旁修补术。其他研究参数无统计学差异。总之,根据Pclos max、Lfun和Pves max值的差异,Burch技术似乎能使患者尿道阻力有更高的增加。