自体筋膜尿道悬吊治疗女性压力性尿失禁的探讨

Autogenous Fascia Urethral Suspension for the Treatment of Female Stress Incontinence

目的:探讨自体筋膜尿道悬吊术在女性压力性尿失禁治疗中的效果。方法:采用经耻骨上入路自体筋膜尿道中段悬吊术治疗女性压力性尿失禁,回顾性分析2000年2月～2007年12月采用该手术方式治疗28例女性压力性尿失禁患者的临床资料和治疗效果。结果:所有患者无耻骨后血肿形成,无尿道损伤;膀胱损伤1例,延长导尿管留置时间后治愈;28例患者术后拔除尿管均能自行排尿并满意控尿,6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9～21个月,平均15个月,无压力性尿失禁症状复发及排尿困难。结论:自体筋膜尿道悬吊术治疗女性压力性尿失禁简单易行,操作安全,损伤性较小,费用低廉。

Objective：To evaluate the efficacy of autogenous fascia urethral suspension for the treatment of fe male stress urinary incontinence （SUI）. Methods：Female patients with stress urinary incontinence were treated by the method of autogenous fascia（anterior sheath of rectus abdominis muscle） urethral suspension via vagina. From Feb 2000 to Dec 2007, clinical data and treatment efficacy of 28 SUI patients were analyzed retrospectively. Resuits：All patients had no retropubic hematoma and urethra injury. 1 patient with bladder injury had been cured after extended the detention time of catheter. After removal of catheters, 28 patients successfully voided without incontinence,detrusor instability developed in 6 patients and were relieved by expectant treatment. All patients were followed up for 9 to 21 months（mean 15 months）, neither recurrence of SUI nor lower urinary tract obstruction was found. Conclusions： Autogenous fascia suspension via vagina was a simple, safe, minimally invasive and low cost method for treatment of female SUI.