【女性压力性尿失禁的手术治疗】。

J Lahodny, B Lahodny, M Birner, A Kaider
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引用次数: 0

摘要

描述了1979-2005年间治疗女性压力性尿失禁的不同手术方法的决定性变化。由于科学认识和多年的应用经验,治疗压力性尿失禁有两种逻辑和解剖学上有充分根据的可能性:用短吊带成形术将膀胱颈部抬高到原来的位置。在做这个的过程中。尿道腱素和光。后尿道通过短吊带成形术或双吊带成形术连接在尿道下,这样膀胱颈被提升到骨盆筋膜腱弓的高度。所以一个水平的膀胱基底板能够收缩膀胱后角约90%的结果。自制的解剖学证据。2. 尿道环绕带对尿道反射的影响。一个周长为1.5 x 2.6 cm的聚丙烯网固定在左右耻骨和左右尿道旁的内表面。这种稳定的吊床使尿道背部产生约2毫米的生理印痕。因此膀胱反射会引起膀胱颈的收缩膀胱逼尿肌的松弛。该微创应激性尿失禁手术方法主观失禁治愈率为83.7%,临床治愈率为97.7%。这意味着与TVT(无张力阴道带)或TOT(经阴道带)后的结果相同。与TVT或TOT相比,UST没有并发症。
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[Operative therapy of female stress incontinence].

Description of the fateful change of the differing operation methods for the treatment of female stress incontinence between 1979-2005. For the reason of scientific cognitions and many years of applying experience there are two logical and anatomical well-founded possibilities for the treatment of stress incontinence: 1. Elevation of the bladder neck to it's original position by a shortarm sling plasty. In doing that vaginally the ligg. urethrotendinea and the ligg. pubourethralia posteriora are connected suburethrally by a shortarm sling plasty or a double sling plasty and in this way the bladderneck is elevated to the height of the arcus tendineus fasciae pelvis. So a horizontal bladder base plate able to contract results with a retrovesical angle of about 90 %. The anatomic proof for continence. 2. Producing of the urethrovesical reflex by UST (Urethra Surrounding Tape). A polypropylene mesh with a circumference of 1,5 x 2,6 cm is fixed to the inner surface of the right and left os pubis and paraurethrally right and left too. This stable hammock causes a physiological impression of the dorsal urethra of about 2 mm. Because of that the urethrovesical reflex is set off leading to the contraction of the bladder neck and the relaxation of the detrusor vesicae muscle. This minimal invasive stress incontinence operation method brings about a subjective incontinence healing rate of 83.7 % and a clinical healing rate of 97.7 %. That means the same results like after TVT (Tension Free Vaginal Tape) or TOT (Transobturatorial Tape). In contrast to TVT or TOT there are no complications with UST.

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