Leach G E, Dmochowski R R, Appell R A, Blaivas J G, Hadley H R, Luber K M, Mostwin J L, O'Donnell P D, Roehrborn C G
J Urol. 1997 Sep;158(3 Pt 1):875-80. doi: 10.1097/00005392-199709000-00054.
The American Urological Association convened the Female Stress Urinary Incontinence Clinical Guidelines Panel to analyze the literature regarding surgical procedures for treating stress urinary incontinence in the otherwise healthy female subject and to make practice recommendations based on the treatment outcomes data.
The panel searched the MEDLINE data base for all articles through 1993 on surgical treatment of female stress urinary incontinence. Outcomes data were extracted from articles accepted after panel review. The data were then meta-analyzed to produce outcome estimates for alternative surgical procedures.
The data indicate that after 48 months retropubic suspensions and slings appear to be more efficacious than transvaginal suspensions, and also more efficacious than anterior repairs. The literature suggests higher complication rates when synthetic materials are used for slings.
The panel found sufficient acceptable long-term outcomes data (longer than 48 months) to conclude that surgical treatment of female stress urinary incontinence is effective, offering a long-term cure in a significant percentage of women. The evidence supports surgery as initial therapy and as a secondary form of therapy after failure of other treatments for stress urinary incontinence. Retropubic suspensions and slings are the most efficacious procedures for long-term success (based on cure/dry rates). However, in the panel's opinion retropubic suspensions and sling procedures are associated with slightly higher complication rates, including longer convalescence and postoperative voiding dysfunction.
美国泌尿外科学会召集女性压力性尿失禁临床指南小组，分析关于在健康女性中治疗压力性尿失禁的外科手术的文献，并根据治疗结果数据提出实践建议。
该小组检索了MEDLINE数据库中截至1993年所有关于女性压力性尿失禁外科治疗的文章。结果数据从小组审查后接受的文章中提取。然后对数据进行荟萃分析，以得出替代外科手术的结果估计值。
数据表明，48个月后耻骨后悬吊术和吊带术似乎比经阴道悬吊术更有效，也比前路修补术更有效。文献表明，使用合成材料制作吊带时并发症发生率更高。
该小组发现了足够多可接受的长期结果数据（超过48个月），得出结论认为女性压力性尿失禁的外科治疗是有效的，能使相当比例的女性获得长期治愈。证据支持手术作为初始治疗方法以及在压力性尿失禁其他治疗失败后的二线治疗方法。耻骨后悬吊术和吊带术是长期成功（基于治愈/干爽率）最有效的手术方法。然而，该小组认为耻骨后悬吊术和吊带手术的并发症发生率略高，包括恢复时间更长和术后排尿功能障碍。
