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女性压力性尿失禁的手术治疗：耻骨后尿道中段悬吊术

Authors
Charles W Nager, MD
Jasmine Tan-Kim, MD
Section Editor
Linda Brubaker, MD, FACOG
Deputy Editor
Kristen Eckler, MD, FACOG
Translators
黄煜, 副主任医师

引言

压力性尿失禁(stress urinary incontinence, SUI)累及4%-35%的女性[1,2]。当腹腔内压力增加超过了尿道闭合压，从而导致非自主性漏尿时，即发生SUI。这可能在用力、打喷嚏或咳嗽时出现[3]。

SUI的治疗选择包括保守治疗和手术治疗。尿道中段悬吊术已取代其他手术(如，耻骨后阴道悬吊术、膀胱颈悬吊术)成为众多女性的首选手术[4]。1996年由Ulmsten引入的无张力阴道吊带(tension-free vaginal tape, TVT)是最早由人工合成的耻骨后尿道中段吊带[5]。从那时起，耻骨后尿道中段悬吊带的变型产品和经闭孔尿道中段悬吊带也被引入。

耻骨后尿道中段悬吊术总结在此。经闭孔尿道中段悬吊术和女性SUI的术式选择将单独讨论。 (参见“女性压力性尿失禁的手术治疗：经闭孔尿道中段吊带术”和“女性压力性尿失禁：初始手术方式的选择”和“女性压力性尿失禁的手术治疗：尿道中段悬吊术的选择”)

专业术语

现有几种类型的悬吊手术可用于治疗女性SUI(表 1)。这些术式根据吊带放置部位和吊带材料的不同而有所差异。这些吊带被统称为尿道下吊带，即通过一个小的阴道切口插入并被附于骨盆中另一结构以支撑尿道的一种吊带。尿道下吊带可以是膀胱颈吊带，也可以是尿道中段吊带。

●尿道中段吊带–一种被以无张力方式置于尿道中段水平的尿道下吊带。这些吊带由合成网片制成。

                                             

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Literature review current through: 2017-06 . | This topic last updated: 2016-08-18.
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