Rovner E S, Ginsberg D A, Raz S
Department of Urology, University of California Los Angeles School of Medicine, USA.
Urology. 1997 Aug;50(2):273-6. doi: 10.1016/S0090-4295(97)00268-9.
To describe a simple, yet effective method of adjusting intraoperative tension on the suspending sutures of a vaginal wall sling placed for treatment of stress urinary incontinence (SUI) in the female patient.
A cystoscope sheath is placed per urethra and inclined to approximately 20 degrees to 30 degrees relative to horizontal. The suspension sutures are tied down directly onto the rectus fascia but do not indent it. The sheath should easily rotate in the vertical plane within the urethral lumen, maintaining elastic mobility as the sutures are tied.
On review of the first 160 patients who have undergone vaginal wall sling using this technique of tension adjustment, no patient has had unexpected permanent urinary retention. Preoperative urgency incontinence has remained in 10 patients (less than 7%) postoperatively; 11 patients (6.8%) have had recurrent SUI during follow-up.
Proper adjustment of suture tension during performance of a sling procedure for SUI is critical in preventing urethral obstruction. The technique described is simple, objective, reproducible, and highly effective.
描述一种简单而有效的方法，用于调整为治疗女性压力性尿失禁（SUI）而放置的阴道壁吊带术中悬吊缝线的张力。
经尿道置入膀胱镜鞘，使其相对于水平方向倾斜约20度至30度。将悬吊缝线直接系在腹直肌筋膜上，但不要使其凹陷。鞘应能在尿道腔内垂直平面内轻松旋转，在系紧缝线时保持弹性移动性。
回顾使用这种张力调整技术进行阴道壁吊带手术的前160例患者，没有患者出现意外的永久性尿潴留。术前急迫性尿失禁在术后仍存在于10例患者中（不到7%）；11例患者（6.8%）在随访期间出现复发性SUI。
在进行SUI吊带手术时正确调整缝线张力对于预防尿道梗阻至关重要。所描述的技术简单、客观、可重复且高效。
