手術前尿路動力學顯示膀胱無收縮或低收縮不會影響婦女尿失禁手術結果
鄒頡龍、張兆祥、吳錫金中國醫藥大學 醫學系中國醫藥大學附設醫院 泌尿部
PREOPERATIVE AREFLEXIA OR HYPOREFLEXIA DO NOT AFFECT
THE RESULT OF TRANSOBTUROR MID-URETHRAL SLING FOR
PATIENTS WITH STRESS URINARY INCONTINENCE
Eric Chieh-Lung Chou, Chou-Hsiang Chang, His-Chin WuDepartment of Urology China Medical University Hospital, Taichung, Taiwan
Purpose: To investigate the surgical results of using transobturator midurethral sling in the
treatment of women with stress urinary incontinence (SUI) who preoperative cystometry (CMG) showed areflexia or hyporeflexia
Materials and Methods: Medical records of the patients underwent transobturator midurethral
sling for the treatment of SUI from 2010 to 2011 were reviewed. CMG revealed areflexia or hyporeflexia in 12 of those patients. The surgical results and the urodynamic changes were assessed. The results were compared with another 27 patients who preoperative CMG showed normoreflexia.
Results: At a median follow-up of 14 months, 11 patients (91.7 %) were completely continent, 1
(8.3%) had an improvement but with mild SUI, none of them experienced de novo urge incontinence. The treatment result was considered satisfactory by 11 patients (91.7%). Uroflowmetry showed no significant change in max flow rate and residual urine before and after surgery (15.6± 8.6 vs. 14.7± 5.4 mL/sec, p< 0.01; 72.3± 27.1 vs 51.1± 46.2 mL, p< 0.01 ). Two patients had the symptoms of terminal dribbling after surgery. In the group of normoreflexia, 24 patients (88.9 %) were completely continent, 1 (%) had mild SUI, 2 (7.4%) experienced urgency and mild de novo urge incontinence. None the patients of both groups has postoperative urine retention.
Conclusions: Transobturator midurethral sling is effective in treating female SUI with preoperative
CMG showed areflexia or hyporeflexia. None of these patients experienced urine retention or de novo urge incontinence. The results of treatment are comparable to the group with preoperative CMG showed normoreflexia.
論文分類：6
