首页|盆底重建术后泌尿道网片/吊带暴露的手术处理——单中心经验

盆底重建术后泌尿道网片/吊带暴露的手术处理——单中心经验

Surgical management of urinary tract mesh/sling exposure after pelvic floor recon-struction:a single center experience

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目的 对盆底重建术后网片/吊带泌尿道暴露的手术干预方法及长期治疗结局进行分析探讨.方法 对2011年11月—2020年9月四川大学华西医院泌尿外科收治的因经阴道盆底重建术后网片或吊带发生泌尿道暴露再次接受手术治疗的9例患者的临床资料进行回顾性分析,探讨其一般临床特点,再次手术方式及治疗结局.结果 9例患者的中位年龄为53(39~73)岁,身体质量指数中位数为23.0(19.5~27.3).6例患者既往因盆腔脏器脱垂接受经阴道网片植入术而于术后发生网片暴露,其中3例患者接受经阴道部分网片切除术、3例接受膀胱镜下钬激光消融手术.另外3例患者既往因尿失禁接受无张力尿道中段悬吊术而于术后发生吊带暴露,其中2例接受膀胱镜下部分网片切除术治疗,1例接受膀胱镜下钬激光消融手术治疗.9例患者的中位随访时间为69(16~121)个月.截至末次随访时所有患者均未再次发生网片暴露.结论 经阴道途径及经尿道途径的网片/吊带切除术均是治疗盆底重建术后泌尿道网片/吊带暴露的有效手术方法.
Objective To investigate surgical methods and long-term treatment outcomes of urinary mesh/sling urinary tract exposure after pelvic floor reconstruction.Methods A retrospective analysis was performed for 9 patients admitted to the Department of Urology,West China Hospital of Sichuan University during Nov.2011 and Sep.2020 due to urinary tract exposure to mesh or sling after pelvic floor reconstruction.Results The median age of the 9 patients was 53(39-73)years and the median body mass index was 23.0(19.5-27.3).Six patients underwent transvaginal mesh implantation for pelvic organ prolapse,and the remaining 3 patients underwent mid-urethral sling(MUS)surgery due to urinary incontinence.Of the 6 patients who experienced mesh exposure after transvaginal mesh implantation,3 underwent transvaginal mesh removal,and the remaining 3 cystoscopic holmium laser ablation.Among patients who experienced mesh exposure after mid-urethral sling,2 patients underwent transurethral removal and 1 cystoscopic holmium laser ablation.The median follow-up was 69(16-121)months.At the last follow-up,none of the patients had mesh/sling exposure.Conclusion Both transvaginal and transurethral mesh/sling removal are effective surgical methods for the treatment of urinary tract mesh/sling exposure after pelvic floor reconstruction.

pelvic organ prolapsestress urinary incontinencepelvic floor reconstructionmesh exposuresling exposuresurgical treatmenttransvaginal mesh implantationmid-urethral sling surgery

徐帅、张洁、张驰、彭聊、罗德毅

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四川大学华西医院泌尿外科,四川成都 610041

盆腔脏器脱垂 压力性尿失禁 盆底重建术 网片暴露 吊带暴露 手术处理 经阴道网片植入术 无张力尿道中段悬吊术

2024

现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子:1.106
ISSN:1009-8291
年,卷(期):2024.29(8)