小儿骶前畸胎瘤术后小便失禁的外科治疗

The Surgical Treatment of Urinary Incontinence After Sacrococcygeal Teratoma Resection in Children

目的:探讨小儿骶前畸胎瘤术后小便失禁的治疗方法。方法:6～14岁患儿6例,均为骶前畸胎瘤切除术后,表现为排尿异常、逼尿肌无反射、尿道压高于膀胱压。全部患儿均采用双侧髂腰肌加强盆底肌、回肠去粘膜带血管蒂浆肌层加强逼尿肌治疗。随访6个月～3年。结果:本组4例术后有明显改善,2例有改善。结论:双侧髂腰肌加强盆底肌、回肠去粘膜带血管蒂浆肌层加强逼尿肌是治疗骶前畸胎瘤术后小便失禁的一种较好方法。

Objective:To study the surgical procedure to treat urinary incontinence after sacrococcygeal teratoma resection in children.Methods:Six cases aged 6-14 years presented with urinary incontinence,disappearance of detrusor reflex contraction.The urethral pressure was higher than that of the bladder.They underwent bilateral iliopsoas muscles to strengthen pelvic floor and pedicled ileal seromuscular patch to strengthen the detrusor urinae.Results:The follow- up for a period of 6 months to 3 years showed that 4 of them have got obvious urinary continence, and 2 improved.Conclusions:The authors consider that combined bilateral iliopsoas muscles to strenghen the pelvic floor with pedicled ileal seromuscular patch to strengthen detrusor reflex function is a good method to treat urinary incontinence after sacrococcygeal teratoma removal.