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女性压力性尿失禁的手术治疗：经闭孔尿道中段吊带术

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

引言

压力性尿失禁(stress urinary incontinence, SUI)在女性中的患病率为4%-35% [1,2]。当腹内压增加超过尿道闭合压时发生不自主的漏尿即称为SUI。在用力、打喷嚏或咳嗽时就可能发生这种情况[3]。

SUI的治疗包括保守治疗和手术治疗。尿道中段吊带术是一种相对较新的治疗方法，但已成为许多女性患者的首选手术。首例尿道中段吊带术是于1996年实施，术者将穿刺针和网片经耻骨后间隙通过，完成吊带放置[4]。耻骨后尿道中段吊带术现在仍很常用，但为了避免部分耻骨后穿刺操作的并发症(例如，膀胱穿孔、血管损伤、肠损伤)，2001年引入了经闭孔吊带术[5]。经闭孔吊带术是使穿刺针和网片经闭膜管通过而将吊带放置于尿道中段，完全避开了耻骨后间隙。

本文将总结经闭孔尿道中段吊带术。耻骨后尿道中段吊带术和女性SUI手术治疗方式的选择将单独讨论。 (参见“女性压力性尿失禁的手术治疗：耻骨后尿道中段悬吊术”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”)

术语

目前可用于治疗女性SUI的吊带术已有多种类型(表 1)。这些手术因吊带放置的位置和吊带的材料不同而存在差异。但总体来讲，这些吊带术都被称为尿道下吊带术，因为都需要将吊带经小的阴道切口插入并连接到盆腔的另一个结构上以支撑尿道。尿道下吊带术包括膀胱颈吊带术和尿道中段吊带术。

●尿道中段吊带术–是指将尿道下吊带以无张力的方式放置在尿道中段水平。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: 2016-05-26.
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