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目的探讨女性尿道下裂患儿合并排尿困难、尿失禁的原因,并寻找合适的治疗方法。方法总结11例排尿困难、尿失禁而同时合并有尿道下裂的女性病例,接受髂腰肌转移盆底肌悬吊术治疗。结果11例术后随访6～30个月,平均18个月,控尿满意(昼夜均能保持3 h以上完全干燥)7例。好转(部分控尿,白天偶有尿失禁或夜间尿床)3例,无效(症状无改善)1例,总有效率为90.9%。术前最大膀胱容量(162.5±69.8)ml、漏点压(33.4±7.5)cmH_2O(1 cmH_2O=0.098 kPa)、最大尿道压(37.4±12.7)cmH_1O、最大关闭压(23.8±12.2)cmH_2O、功能尿道长度(2.4±1.6)cm;残余尿(93±56)ml;术后分别为(201.6±62.3)ml、(49.8±15.4)cmH_2O、(52.8±14.3)cmH_10、(32.8±11.6)cmH_2O、(3.6±2.0)cm,(25±20)ml,均较术前明显改善(P<0.01)。泌尿系感染频率和程度较治疗前明显减少和减轻。结论髂腰肌转移盆底肌悬吊术可以作为女性尿道下裂合并尿失禁、排尿困难的可供选择的治疗方法。
Objective To investigate the causes of urinary incontinence and urinary incontinence in children with hypospadias and to find out the appropriate treatment. Methods 11 cases of dysuria, urinary incontinence combined with hypospadias in female patients received iliopsoas pelvic muscle pelvic muscle suspension therapy. Results 11 cases were followed up for 6 to 30 months, with an average of 18 months. The patients were satisfied with urine control (all of them were completely dry for more than 3 h). (Partial control of urine, incontinence during the day or nighttime bedwetting) 3 cases, invalid (no improvement in symptoms) in 1 case, the total effective rate was 90.9%. The maximum bladder volume (162.5 ± 69.8) ml, the leakage pressure (33.4 ± 7.5) cmH 2 O (1 cmH 2 O = 0.098 kPa), the maximum urethral pressure (37.4 ± 12.7) cmH 1 O and the maximum closure pressure of 23.8 ± 12.2 cmH 2 O were The length of the urethra was (2.4 ± 1.6) cm and the residual urine was (93 ± 56) ml. The mean length of the urethra was (201.6 ± 62.3) ml, (49.8 ± 15.4) cmH2O, (52.8 ± 14.3) cmH_10 and (32.8 ± 11.6) cmH2O, (3.6 ± 2.0) cm and (25 ± 20) ml respectively, which were significantly improved compared with that before operation (P <0.01). The frequency and extent of urinary tract infection were significantly reduced and relieved compared with those before treatment. Conclusion iliopsoas pelvic muscle pelvic muscle suspension can be used as an alternative treatment for female hypospadias with urinary incontinence and dysuria.