- 期刊
The Effects on Vesicourethral Function Following Laparoscopic Hysterectomy
腹腔鏡子宮切除術對排尿功能的影響
摘要
長久以來，子宮切除術後是否會對排尿功能有不良影響一直未有定論。近年來，由於腹腔鏡手術的發展一日千里，使我們更有必要去了解其可能引起的併發症。在本研究中，共有45位病患接受腹腔鏡子宮切除術，我們分別在術前、術後做了尿液分析、問卷調查及尿路動力學上的各種檢查。結果發現雖然有排尿症狀的病人個數，在術前、後的改變沒有意義，但在頻尿及應力性尿失禁的比例卻呈有意義的減少。此外，尿路動力學上的檢查亦發現最大尿道閉鎖壓及膀胱容量呈有意義的上升。所以結論是：腹腔鏡子宮切除術並不會對解尿功能造成傷害，而且有些病人的頻尿及尿失禁症狀可能在術後獲得改善。
關鍵字
無資料並列摘要
The aim of our study is to determine whether laparoscopic hysterectomy is associated with increased postoperative urinary symptoms and to assess the change in urodynamic parameters after operation. Forty-five women were arranged for laparoscopic hysterectomy (LH). Each patient received urinalysis, interview, and urodynamic study including uroflowmetry, filling and voiding cystometry and urethral pressure profilometry before and after hysterectomy. A total of 27 patients (60%) had urinary symptoms preoperatively. After operation, only 22 patients (48.9%) remained symptomatic. There was no significant change in the number of women with one or more voiding symptoms before and after surgery, but the incidence of urinary frequency and stress incontinence decreased significantly after laparoscopic hysterectomy(P＜0.05). In addition, maximal urethral closure pressure and maximal cystometric capacity showed significant increases after operation. They were 73.1 cm H2O (range: 49-114) vs 104.4 cm H2O (range: 60-147) (P＜0.00l), and 363.3ml (range: 287-423) vs 396.1ml (range: 265-515) (P＜0.00l), respectively. The result indicated that laparoscopic hysterectomy did not significantly increase the subjective or objective incidence of vesicourethral dysfunction. On the contrary, some patients might be cured of urinary frequency or stress incontinence postoperatively.