British journal of obstetrics and gynaecology · 1995
A follow up of silastic sling for genuine stress incontinence.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chin Y K, Stanton S L
Аннотация
OBJECTIVE: To assess the use of silastic sling for genuine stress incontinence.
DESIGN: Retrospective descriptive analysis.
SETTING: Tertiary referral centre for urogynaecology.
SUBJECTS: Eighty-eight women with urodynamically proven genuine stress incontinence, 10 had coexistent detrusor instability. In 74 women, the sling operation was for recurrent incontinence.
INTERVENTION: A low Pfannenstiel incision was used and a suburethral tunnel dissected to insert the sling, which was attached under minimal tension with non-absorbable sutures to each ileopectineal ligament.
MAIN OUTCOME MEASURES: Clinical and urodynamic data were assessed between two and three months post-surgery; thereafter clinical assessment and pad testing were performed at yearly intervals for five years.
RESULTS: The subjective cure at three months was 81% and the objective cure was 69%. There was a fall in success rate with increasing number of continence operations, and this was statistically significant for women with three or more previous continence operations (P < 0.05). Neither age, parity nor menopausal status made a statistical difference to the cure rate. Twenty-three women had reached their fifth year follow up and the success rate using life table analysis was 71%. Post-operatively, 29 women had detrusor instability: 22 women developed detrusor instability de novo and seven had detrusor instability presurgery. Urodynamic findings postsurgery showed an increase (P < 0.001) in outflow resistance. Four women required removal of sling for voiding difficulties. Ten women developed sling erosions: five vaginal, four bladder erosions and one urethral erosion. After removal of the sling, seven women still remained continent.
CONCLUSIONS: A silastic sling operation for the treatment of genuine stress incontinence provides a good long term cure, considering that 45% of women had two or more previous failed continence operations. The high prevalence of detrusor instability and voiding difficulties postsurgery should be noted.
DESIGN: Retrospective descriptive analysis.
SETTING: Tertiary referral centre for urogynaecology.
SUBJECTS: Eighty-eight women with urodynamically proven genuine stress incontinence, 10 had coexistent detrusor instability. In 74 women, the sling operation was for recurrent incontinence.
INTERVENTION: A low Pfannenstiel incision was used and a suburethral tunnel dissected to insert the sling, which was attached under minimal tension with non-absorbable sutures to each ileopectineal ligament.
MAIN OUTCOME MEASURES: Clinical and urodynamic data were assessed between two and three months post-surgery; thereafter clinical assessment and pad testing were performed at yearly intervals for five years.
RESULTS: The subjective cure at three months was 81% and the objective cure was 69%. There was a fall in success rate with increasing number of continence operations, and this was statistically significant for women with three or more previous continence operations (P < 0.05). Neither age, parity nor menopausal status made a statistical difference to the cure rate. Twenty-three women had reached their fifth year follow up and the success rate using life table analysis was 71%. Post-operatively, 29 women had detrusor instability: 22 women developed detrusor instability de novo and seven had detrusor instability presurgery. Urodynamic findings postsurgery showed an increase (P < 0.001) in outflow resistance. Four women required removal of sling for voiding difficulties. Ten women developed sling erosions: five vaginal, four bladder erosions and one urethral erosion. After removal of the sling, seven women still remained continent.
CONCLUSIONS: A silastic sling operation for the treatment of genuine stress incontinence provides a good long term cure, considering that 45% of women had two or more previous failed continence operations. The high prevalence of detrusor instability and voiding difficulties postsurgery should be noted.