腹圧性尿失禁に対する恥骨固定式膀胱頸部吊り上げキット(Vcsica)を用いた治療経験

Abstract

腹圧性尿失禁9例に対しVesicaを用いた膀胱頸部吊り上げ術を経験した.1)後部尿道膀胱角, パッドテスト共に改善が認められた.2)2例の尿閉を経験したが, 各々7日間の間歇導尿, カテーテル再留置にて改善した.3)術後切迫失禁を7例に認めたが, 一時的な抗コリン剤の内服で改善した.以上より少数例であり短期間の観察期間ではあるが, 腹圧性尿失禁に対するVesicaを用いた膀胱頸部吊り上げ術は有用である

We experienced 9 cases of percutaneous bladder neck stabilization (Vesica) for patients with urinary incontinence who were diagnosed with stress incontinence from December 1995 to June 1998. None of the patients were able to control continence with any drugs. Chain cystography was performed on all of the patients before and after surgery. The posterior urethro-vesical angle before surgery was over 130 degrees in all of the patients, and it improved after the operation. Moreover, the mean volume of the pad test greatly decreased from 47 g to 1 g. All of the patients were treated with epidural anesthesia. The operation time was less than 60 minutes. The subjective and objective findings were satisfactory. We conclude that percutaneous bladder neck stabilization is a very useful surgical treatment for stress incontinence.