Cross C A, Cespedes R D, McGuire E J
Department of Obstetrics, Gynecology and Reproductive Medicine, University of Texas Medical School at Houston, USA.
J Urol. 1998 Apr;159(4):1195-8.
Pubovaginal slings successfully treat stress urinary incontinence in women with intrinsic sphincter deficiency. Because of its durability, it has been an attractive procedure in select patients with urethral hypermobility. We examine our experience with pubovaginal sling.
A total of 150 patients were evaluated for pelvic prolapse and urinary incontinence. An abdominal leak point pressure was determined in all patients. Of patients with type II stress urinary incontinence, 36 patients (80%) underwent additional gynecological procedures at the time of the pubovaginal sling, compared to 29% with intrinsic sphincter deficiency and 33% with coexisting urethral hypermobility and intrinsic sphincter deficiency.
The overall cure rate was 93% with a mean followup of 22 months. At 1 week postoperatively spontaneous voiding was accomplished by 56% of the patients with urethral hypermobility and 57% with intrinsic sphincter deficiency. Only 2.8% of patients required surgical therapy for prolonged urinary retention. De novo urgency/urge incontinence occurred in 19% of women with a 3% incidence of persistent urge incontinence.
Pubovaginal slings are effective and durable. Voiding dysfunction is uncommon and is temporary in most patients.
耻骨后阴道吊带术能成功治疗存在固有括约肌缺陷的女性压力性尿失禁。因其耐久性，对于部分尿道活动过度的患者而言，该手术颇具吸引力。我们回顾了我们在耻骨后阴道吊带术方面的经验。
共对150例盆腔器官脱垂和尿失禁患者进行了评估。测定了所有患者的腹压漏尿点压力。在Ⅱ型压力性尿失禁患者中，36例（80%）在耻骨后阴道吊带术时还接受了其他妇科手术，而固有括约肌缺陷患者中这一比例为29%，同时存在尿道活动过度和固有括约肌缺陷的患者中这一比例为33%。
总体治愈率为93%，平均随访22个月。术后1周时，尿道活动过度患者中有56%、固有括约肌缺陷患者中有57%可自主排尿。仅2.8%的患者因持续性尿潴留需要手术治疗。19%的女性出现了新发尿急/急迫性尿失禁，持续性急迫性尿失禁的发生率为3%。
耻骨后阴道吊带术有效且持久。排尿功能障碍并不常见，且在大多数患者中是暂时的。
