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随着对尿失禁机制研究的深入,引发一系列新的尿失禁手术方法。本文介绍了有关手术的概述、要点、适应证、并发症的处理及疗效,对每种手术的特点加以评述:①经阴道前壁韧带筋膜吊带术中的同种异体筋膜方法远期疗效更好;②经尿道无张力尿道中段吊带术(TVT)对尿道解剖结构异常及内源性尿道缺损引起的女性压力性尿失禁都有效,是目前应用较广的术式;③经闭孔尿道中段吊带术与TVT疗效相同,可减少手术操作时间和膀胱损伤;④经阴道尿道耻骨悬吊术结合了传统的尿道悬吊术和吊带术,远期复发率低;⑤内腔镜下注射胶原体,简便、安全,可多次治疗;⑥射频治疗尿失禁是一种新疗法,无需外来材料,远期疗效有待观察;⑦骶神经调控术对难治性急迫性尿失禁不失为一种有效的方法;⑧人工尿道括约肌术给严重的尿失禁带来希望;⑨尿道球部/阴茎海绵体间置术,对前列腺术后尿失禁完全性尿失禁可采用。
With the deepening of research on urinary incontinence mechanism, triggering a series of new urinary incontinence methods. This article describes the outline of the surgery, points, indications, complications and treatment, and to review the characteristics of each operation: ① transvaginal anterior ligament fasciosis fascia allograft fascia method long-term efficacy Better; Transurethral tension-free mid-urethral sling (TVT) on the anatomical structure of the urethra and endogenous urethral defects caused by female stress urinary incontinence are valid, is currently widely used surgical procedures; ③ trans-closed-cell urethra The middle strap and TVT the same effect, can reduce the operation time and bladder injury; ④ transvaginal urethral suspension combined with the traditional urethral suspension and sling, long-term recurrence rate is low; ⑤ endoscopic injection of collagen ⑥ radio frequency treatment of urinary incontinence is a new treatment without foreign materials, long-term efficacy remains to be seen; ⑦ sacral nerve control surgery for refractory urge incontinence is an effective ⑧ artificial urethral sphincter surgery to bring serious hope of urinary incontinence; ⑨ urethral bulb / penile cavernous surgery, postoperative prostate incontinence of complete urinary incontinence can be used.