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- The Mechanism of Successful Colposuspension in Genuine Stress Incontinence
- Efficacy of Laparoscopic Colposuspension in the Treatment of Genuine Stress Incontinence
- Efficacy of Pelvic Floor Rehabilitation for Treatment of Genuine Stress Incontinence
- 尿道注射膠原蛋白及其它充填劑治療應力性尿失禁
- 婦女應力性尿失禁之病理生理學觀點
- 恥骨陰道吊帶手術之作用
- Uterine Preservation in the Surgical Management of Uterine Prolapse: A Laparoscopic Approach
- 淺談婦女應力性尿失禁
- Evaluation of Urodynamics for the Diagnosis of Female Stress Urinary Incontinence
- 一位應力性尿失禁婦女術後之護理經驗
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題 名 | The Mechanism of Successful Colposuspension in Genuine Stress Incontinence=陰道懸吊術成功治療應力性尿失禁的機轉 |
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作 者 | 陳慧毅; 林武周; 蔡鴻德; | 書刊名 | 中華醫學雜誌 |
卷 期 | 61:3 民87.03 |
頁 次 | 頁146-150 |
分類號 | 416.274 |
關鍵詞 | Burch式手術; 陰道懸吊術; 應力性尿失禁; Burch procedure; Colposuspension; Genuine stress incontinence; |
語 文 | 英文(English) |
中文摘要 | 背景:陰道懸吊術(Burch式手術)已成為手術治療應力性尿失禁的有效方法之一,本研究在探討陰道懸吊術成功治療應力性失禁的機轉。 方法:本研究共有三十五位應力性尿失禁患者接受陰道懸吊手術,術前評估包括詳細理學檢查、尿液分析、骨盤底檢查,一小時棉墊試驗、Q-tip試驗、尿動力學檢查、會陰超音波等。術後一年追蹤評估治療的效果。 結果:本研究中,術後完全沒有尿失禁或症狀明顯改善者佔82.9%(包括治癒者為71.4%,明顯改善為11.4%),術後併發症的發生率為20%。而在成功組的尿動力學檢查,其最大尿道閉鎖壓力及尿道壓力傳導率,皆具統計學上有意義的改變。會陰超音波及 Q-tip試驗的結果顯示,膀胱頸的下降得到統計學上有意義的校正。 結論:本研究顯示:陰道懸吊術成功治療應力性尿失禁的機轉,在於恢復膀胱頸正常的解剖學位置,及改善尿道壓力傳導率的程度。 |
英文摘要 | Background. Colposuspension (Burch procedure) is one of the most effective surgical procedures for the cure of genuine stress incontinence in women. The aim of the current study was to understand the mechanism of successful colposuspension for treatment of this condition. Methods. Thirty-five patients with primary genuine stress incontinence underwent colposuspension. Preoperative investigation included detailed history taking, urinalysis, pelvic floor relaxation assessments, one-hour pad test, Q-tip test, urodynamic study and perineal ultrasound urethrocystography. Follow-up results were estimated after one year. Results. Twenty-five (71.4%) patients were completely cured; four (11.4%) patients showed significant improvement and six (17.1%) had recurrence of incontinence. The overall success rate was 82.9%. The complication rate was 20%. Urodynamic data revealed a significant increase in the maximal stress urethral closure pressure and proximal urethral transmission ratios. Perineal ultrasound urethrocystography and Q-tip test revealed a significant anatomic correction in bladder neck descent. Conclusions. This study confirmed that surgical cure of urinary incontinence can be achieved by restoration of the vesical neck from a dependent position in the pelvis to a position high behind the symphysis pubis, with subsequent improved pressure transmission ratios. |
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