Breen J M, Geer B E, May G E
Division of Gynecology, University of Tennessee, Chattanooga, Baroness Erlanger Medical Center, USA.
Am J Obstet Gynecol. 1997 Dec;177(6):1363-5; discussion 1365-6. doi: 10.1016/s0002-9378(97)70076-0.
The purpose of this study was to evaluate the effectiveness of the fascia lata suburethral sling procedure in the treatment of recurrent genuine urinary stress incontinence.
This study was a retrospective analysis of 60 patients who had a suburethral fascia lata sling placement between January 1992 and December 1995. Follow-up ranged from 6 months to 3.5 years. The database was obtained by a retrospective chart review, a written questionnaire, and telephone interview.
Between January 1992 and December 1995, 72 patients who had at least one previous incontinence procedure were assessed by urodynamic testing and cystourethroscopic examination before undergoing a fascia lata sling placement. Of this population, 60 were available for follow-up. Of this 60, 54, or 90%, had complete cure or marked improvement in the urinary incontinence. There were six failures, two of which had no bladder neck mobility and two of which had detrusor instability and were unable to take medication because of medical contraindications. In addition, two slings were sacrificed because of postoperative complications. The most common postoperative complication was urinary retention, which resulted in eight, or 13.4%, of slings needing to be released.
Our data support the use of the suburethral fascia lata sling as an effective method for the treatment of recurrent genuine urinary stress incontinence, with urinary retention being the most common postoperative complication.
本研究旨在评估阔筋膜尿道下悬吊带术治疗复发性真性压力性尿失禁的有效性。
本研究是一项回顾性分析,对1992年1月至1995年12月间接受尿道下阔筋膜悬吊带置入术的60例患者进行分析。随访时间为6个月至3.5年。通过回顾性病历审查、书面问卷和电话访谈获取数据库。
1992年1月至1995年12月间,72例既往至少接受过一次尿失禁手术的患者在接受阔筋膜悬吊带置入术前接受了尿动力学检测和膀胱尿道镜检查。在这一人群中,60例可供随访。在这60例中,54例(即90%)尿失禁得到完全治愈或明显改善。有6例失败,其中2例膀胱颈无活动度,2例逼尿肌不稳定且因医学禁忌无法用药。此外,2例悬吊带因术后并发症而取出。最常见的术后并发症是尿潴留,导致8例(即13.4%)悬吊带需要松解。
我们的数据支持将阔筋膜尿道下悬吊带术作为治疗复发性真性压力性尿失禁的有效方法,尿潴留是最常见的术后并发症。