局麻下Sparc吊带术治疗女性压力性尿失禁(附42例报告)

Sparc^(TM) sling system for the treatment of female stress urinary incontinence under local anesthesia (report of 42 cases)

目的 介绍耻骨上入路无张力尿道吊带术 (Sparc)治疗女性压力性尿失禁 (SUI)的经验。 方法 局麻下采用Sparc吊带术治疗SUI患者 4 2例。平均年龄 5 4岁 ,病史 12年 ,腹腔漏尿点压(ALPP) <6 0cmH2 O ,剩余尿量均 <2 0ml。 4例伴不稳定膀胱。手术时间平均 2 0min ,术后次日晨拔除尿管自行排尿 ,4周内避免过度活动。 结果 4 2例患者术后拔除尿管均能自行排尿并满意控尿。 7例患者出现不同程度不稳定膀胱症状 ,经对症处理缓解。随访 3～ 12个月 ,平均 6个月 ,无SUI症状复发及排尿困难 ,无与移植物有关的并发症发生。 结论 局麻下Sparc吊带术治疗SUI简便、安全 。

Objective To introduce and evaluate the procedure of suprapubic tensionless Sparc TM sling system in treating female stress urinary incontinence (SUI). Methods A total of 42 patients (mean age,54 years) diagnosed with SUI (a mean course of 12 years) were treated by Sparc TM sling method.Of them 4 cases had detrusor instability.Under local anesthesia,this procedure took about a mean of 20 min.The urinary catheters were removed the next morning after the procedure.The patients were counseled on abstaining from heavy lifting,exercises and intercourse for 4 weeks. Results After removal of catheters,all the 42 patients successfully voided without incontinence.Detrusor instability to various degrees developed in 7 patients and was relieved by expectant treatment.All the patients were followed up for 3 to 12 months (mean,6 months).Neither recurrence of SUI nor lower urinary tract obstruction was found.No implant related complications such as local irritation,extrusion,erosion through the urethra,migration from the desired location,fistula formation and inflammation occurred. Conclusions Sparc TM sling system is a simple,safe and efficacious method of treating SUI under local anesthesia.