Hilton P, Ward A, Molloy M, Umana O
Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(2):118-21. doi: 10.1007/BF01982221.
The aim of the study was to assess the effectiveness of periurethral injection of autologous fat for the treatment of stress incontinence caused by inherent sphincter weakness in women following the repair of obstetric urogenital fistulae. Ten patients with symptomatic stress incontinence following repair of vesicovaginal or urethrovaginal fistula of obstetric origin were assessed clinically, by cystourethroscopy, and by Valsalva leak-point pressure (VLPP). Four showed some degree of bladder neck mobility and were treated by bladder neck suspension procedures. Six appeared to have pure sphincter weakness and were treated by periurethral injection of autologous fat. For logistic reasons, the initial follow-up was undertaken 2 weeks postoperatively, including clinical assessment and VLPP. Two patients were subjectively cured, 2 improved and 2 perceived no change in their symptoms following the procedure. The symptomatic changes correlated with the operative appearance, and with the subsequent changes in VLPP. Although numbers are small and follow-up short, we feel that these preliminary results justify further investigation of the technique in this most difficult group of patients.
本研究的目的是评估经尿道周围注射自体脂肪治疗产科泌尿生殖瘘修补术后女性因固有括约肌功能不全所致压力性尿失禁的有效性。对10例产科来源的膀胱阴道瘘或尿道阴道瘘修补术后出现症状性压力性尿失禁的患者进行了临床评估、膀胱尿道镜检查及瓦尔萨尔瓦漏尿点压力（VLPP）测定。4例表现出一定程度的膀胱颈活动度，接受了膀胱颈悬吊术治疗。6例似乎存在单纯括约肌功能不全，接受了经尿道周围注射自体脂肪治疗。出于后勤方面的原因，术后2周进行了首次随访，包括临床评估和VLPP测定。2例患者主观上治愈，2例症状改善，2例术后症状无变化。症状变化与手术所见及随后VLPP的变化相关。尽管病例数少且随访时间短，但我们认为这些初步结果证明有必要对这组最难治疗的患者进一步研究该技术。
