膀胱颈折叠成形术治疗女童短尿道畸形所致尿失禁8例

Bladder neck folding procedure for treatment of urinary incontinence caused by short urethra in girls：8 case reports

目的探讨膀胱颈折叠成形术治疗女童短尿道畸形所致压力性尿失禁的临床经验和疗效。方法对本院从2008年5月至2011年2月因尿失禁收治的8例女童施行膀胱颈折叠成形术。8例患儿中，包括先天性短尿道畸形6例，1例合并先天性直肠肛门畸形术后，尿道开口发育差，位置偏后汐p伤性尿道阴道瘘、尿道会师术后尿失禁1例，先天性短尿道畸形合并右侧异位发育不良肾、异位输尿管口1例。结果8例患儿手术顺利，恢复良好，术后12～14d出院。术后1个月、3个月、6个月门诊随访，6例控尿满意，元尿失禁、排尿困难、尿路感染等并发症，1例（先天性短尿道畸形合并右侧异位发育不良肾、异位输尿管E1）术后存在尿失禁，1例（先天性短尿道畸形合并先天性直肠肛门畸形术后）存在部分性尿失禁。8例术后彩超提示膀胱元残余尿、无肾盂积水、膀胱结石等。结论短尿道畸形是女性尿失禁的原因之一，严重影响患儿日常生活，膀胱颈折叠术对短尿道畸形所致尿失禁疗效满意，术式简单安全，并发症少，值得临床推广。

Objetive To evaluate clincal application and therapeutic efficacy of Bladder neck folding procedure for treatment of stress urinary incontinence caused by short urethra in girls. Method From May 2008 to February 2011, g girls with urinary incontinence received Bladder neck folding procedure, including 6 girls with congenital short urethra, in which one was after operation of congenital anorectal malformation with a posterior poorly developed urethral opening , one girl with traumatic urethral fistula, urinary incontinence after urethral realignment, and one with congenital short urethra with right poorly developed ectopic kidney and ec- topic ureteral orifice. Results All the operation was successfully performed. 8 girls recovered well and dis- charged 12 - 14 days postoperatively. All girls have been followed up at 1 month, 3 months, and 6 months postoperatively , 6 girls could completely control their urinating without urinary incontinence, dysuresia, urina- ry tract infection or other complications, one girl who was congenital short urethra with right poorly developed ectopic kidney and ectopic ureteral orifice still had urinary incontinence, and the last one who was after opera- tion of congenital anorectal malformation had partial urinary incontinence. No hydronephrosis , bladder calculi was discovered by ultrasonography at each follow - up visit. Conclusion Short urethra as one of the reasons of girl urinary incontinence, seriously affected the daily lives of girls, Bladder neck folding procedure for urinary incontinence caused by short urethra was a simple and safe procedure, with less complications and evident effi-cacy. The authors feel this technique is worthy of popularizing in suitable patients.