Smith C A, Smith E A, Parrott T S, Broecker B H, Woodard J R
Division of Urology, Wayne State University, Children's Hospital of Michigan, Detroit, USA.
J Urol. 1998 May;159(5):1675-9. doi: 10.1097/00005392-199805000-00089.
We reviewed our experience with patients with the prune-belly syndrome who had undergone Monfort abdominoplasty to assess whether our clinical impression of improved voiding efficiency could be demonstrated objectively.
From 1990 to 1993, 12 patients with the prune-belly syndrome underwent Monfort abdominoplasty with or without concomitant genitourinary reconstruction. All patients completed questionnaires on voiding before and after abdominoplasty, incontinence, bladder sensation, urinary flow, history of urinary tract infections and the ability to defecate. Urodynamic testing was performed in 8 patients before and after abdominoplasty.
Subjective changes that occurred after abdominoplasty included resolution of or less double voiding in 9 patients, improved urinary continence in 7, improved bladder fullness sensation in 11, improved urinary flow in 10 and improved defecation in 5. The incidence of urinary tract infections decreased from a preoperative average of 5.7 per patient per year to 1.2 per patient per year postoperatively. Urodynamics demonstrated no significant changes in the measured urinary flow, capacity or maximal detrusor pressure. Compliance decreased on average but it remained in the compliant range. However, post-void residual volumes did significantly decrease from a preoperative average of 40.3% of bladder capacity to 13% after abdominoplasty. If the 5 patients who underwent concomitant urinary reconstruction were excluded, the reduction in average post-void residuals remained approximately the same, which was 40% of bladder capacity preoperatively to 14.3% after abdominoplasty. These data suggest that abdominoplasty alone was responsible for improved micturition.
In addition to the cosmetic benefits and exposure provided for genitourinary reconstruction Monfort abdominoplasty seems to improve voiding efficiency.
我们回顾了接受蒙福特腹壁成形术的梅干腹综合征患者的治疗经验，以评估我们关于排尿效率提高的临床印象是否能得到客观证实。
1990年至1993年，12例梅干腹综合征患者接受了蒙福特腹壁成形术，部分患者同时进行了泌尿生殖系统重建。所有患者均完成了关于腹壁成形术前、后排尿、尿失禁、膀胱感觉、尿流、尿路感染史及排便能力的问卷调查。8例患者在腹壁成形术前、后进行了尿动力学检查。
腹壁成形术后出现的主观变化包括9例患者的二次排尿消失或减少，7例患者尿失禁改善，11例患者膀胱充盈感改善，10例患者尿流改善，5例患者排便改善。尿路感染的发生率从术前平均每位患者每年5.7次降至术后每位患者每年1.2次。尿动力学检查显示，测量的尿流、容量或最大逼尿肌压力无显著变化。顺应性平均下降，但仍在顺应范围内。然而，排尿后残余尿量从术前平均占膀胱容量的40.3%显著降至腹壁成形术后的13%。如果排除5例同时进行泌尿重建的患者，排尿后残余尿量的平均减少幅度大致相同，即从术前占膀胱容量的40%降至腹壁成形术后的14.3%。这些数据表明，单纯腹壁成形术可改善排尿。
除了为泌尿生殖系统重建提供美观效果和手术视野外，蒙福特腹壁成形术似乎还能提高排尿效率。
