三孔法腹膜外途径腹腔镜下Burch术治疗女性压力性尿失禁25例疗效分析

Clinical efficacy of extraperioneal three-port laparoscopic Burch suspension in the treatment of female stress urinary incontinence

目的探讨腹腔镜下经腹膜外途径膀胱颈Cooper韧带悬吊术(Burch手术)治疗女性压力性尿失禁的有效性和安全性。方法采用经腹腔镜下腹膜外途径为25例女性压力性尿失禁患者施行Burch手术。自肚脐下2cm处切开皮肤并制造腹膜外空间,用2-0薇荞线将尿道旁侧的阴道壁肌层"8字"缝合后再缝合到同侧Cooper韧带上。结果所有手术均成功,手术时间29~50min,平均(36.2±8.4)min。术中出血量5~20mL,术后肛门通气时间3~28h,平均(18.6±10.2)h,术后住院时间4~7d。23例均获得随访,随访时间2月~4年,所有病例均无感染、膀胱损伤、排尿困难、复发等并发症。结论腹腔镜下经腹膜外途径Burch术是治疗压力性尿失禁的有效方法,具有创伤及疤痕小、恢复快、住院时间短的优势。

Objective To explore the safety and efficacy of extraperioneal three-port laparoscopic Burch operation in the treatment of female stress urinary incontinence(SUI).Methods Extraperioneal three-port laparoscopic Burch suspension was performed on 25 female SUI patients.Extraperitoneal space was created 2 cm below the umbilicus.The muscular layer of the vaginal wall was sutured as 8-shaped and then fixed to Cooper’s ligament on each side with proper tension.Results All operations were successful.The operation time was 29-50 min,average 36.2 min;intraoperative blood loss was 5-20 mL;anus ventilation time was 3-28 h,average 18.6 h;postoperative hospitalization stay was 4-7 d.During the follow-up of 2 months to 4 years,no infection,bladder injury,dysuria or other complications occurred.Conclusion Extraperioneal laparoscopic Burch suspension is an effective treatment for SUI with advantages of minimal invasion,quick recovery and short hospitalization.