學術論壇
學術論壇可提供瀏覽者及一般會員閱讀瀏覽學術文章。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李偉嘉 | 以手術移除抗失禁手術後所造成膀胱出口阻塞的價值：一個臨床決定的幫手。 | 2016/4/28 下午 09:57:08 | 0 |
| 原 文 | 題 目 | The Value of Surgical Release After Obstructive Anti-Incontinence Surgery: An Aid for Clinical Decision Making |
| 作 者 | Thomas Van den Broeck Dirk De Ridder and Frank Van der Aa* | |
| 出 處 | Neurourology and Urodynamics 34:736–740 (2015) | |
| 出版日期 | 2015年 | |
| 評 論 | 目前，由於理論與技術的成熟，以各式懸吊手術，進行婦女應力性尿失禁的手術，大為盛行。因此，在眾多手術的數量之下，不免出現一些無法避免的合併症，而有可能需要移除或局部切斷這個吊帶。對於臨床醫師來說，這種處置可說相當困擾，且對於移除吊帶手術的結果有許多不定性。以本文研究的結果顯示，如果在吊帶手術約六個月之後，再進行吊帶切除或移除手術，較不會再出現應力性尿失禁。而在吊帶手術施行後約70天之內移除，則比較不會產生新發之膀胱過動症。因此，這樣的統計結果可以提供臨床醫師，在建議移除懸吊帶手術的ㄧ個參考。 | |
| abstract |
Aims: To present satisfaction rates after surgical release of obstructive anti-incontinence surgery, to look for predictive factors for outcome and to define the optimal moment to perform the surgical release. Methods: We reviewed the charts of 87 women at first, second, and last follow-up at a median of 2 (0.5–7), 4 (2–12), and 108 (29–156) months after surgical release. Obstruction was defined as urinary retention, straining to void after overcorrected anti-incontinence treatment or urodynamic bladder outlet obstruction. Patients’ satisfaction was assessed using a 4 point Likert scale. Results: Satisfaction rates at first, second, and last follow-up were 66% (n = 54/82), 54% (n = 37/69), and 74% (n = 43/58) respectively. Postoperatively, patients complained about overactive bladder (OAB) symptoms in 37% (n 1⁄4 30/81) and SUI in 28% (n 1⁄4 23/81) at first follow-up and in 41% (n = 28/68) and 27% (n =18/68) at second follow-up for OAB symptoms and stress urinary incontinence (SUI) respectively. When surgical release was performed more than 180 days after original surgery, less SUI (P=0.008) was reported. When performed within 70 days in patients without pre-operative OAB symptoms, less post-operative OAB symptoms (P=0.05) were reported. Conclusions: Surgical release can be very successful in relieving obstruction due to bladder outlet obstruction (BOO) after anti-incontinence surgery. Persistent OAB symptoms and recurrent SUI are the main reasons for being dissatisfied. To lower the odds for recurrent SUI, surgical release should be performed more than 180 days after original surgery. Patients without pre-operative OAB symptoms are at higher risk of developing post-operative OAB symptoms when treatment is delayed more than 70 days. |
|
| 回覆發表 | 回覆討論主題內容 | 最後發表 |
| 目前尚無任何相關的回覆資料 | ||