Seventy-nine patients of bladder neck suspension using an extraperitoneal variation of laparoscopic surgery were performed for the treatment of stress urinary incontinence. Using a balloon dissector the anterior vesical pelvic space is secured. The bladder neck suspension similar to the Burch operation was performed through a laparoscopic procedure. Symptoms of patients were assessed preoperatively and at one and six months following surgery. Operative times and complications were also evaluated. Success rate was 89.8% at six months. Complications such as bladder perforations were observed. Laparoscopic extraperitoneal bladder neck suspension-(LEBNS) is a viable option to the conventional methods of suspension, it has definite cosmetic advantages, is devoid of intraperitoneal dissection and adhesion, and has a comparable success rate.
Adult ; Aged ; Bladder/anatomy & histology/*surgery ; Female ; Human ; Laparoscopy/methods ; Length of Stay ; Middle Age ; Postoperative Complications ; Quality of Life ; Retrospective Studies ; Urinary Incontinence, Stress/*surgery

背景专家委员会制定的卒中康复指南应用于退伍军人健康管理部门及国防部卫生保健系统。方法根据以前发表的指南,委员会利用美国预防服务特别工作组制定的标准,评价了截至到2002年发表的文献。指南根据临床随机化实验、非对照性研究等证据提出建议(如缺乏确定的数据则根据专家组的建议)。结果Ⅰ级水平的建议包括:在多学科康复环境中或卒中单元中传递卒中治疗,通过NI HSS对卒中患者进行评价,早期启动康复治疗,对吞咽困难患者进行吞咽功能筛查,积极进行二级预防,预防深静脉血栓等。推荐应用标准化的评价工具制定适合每个患者的全面的治疗计划。强烈建议进行抗抑郁及情感波动方面的治疗。语言治疗师应评价患者的交流及认知障碍,并在需要时提供治疗。患者、家属及护理者是康复小组的重要成员,应当介入康复的全部疗程。这些建议在以下网站可查询:httP://stroke.ahajournals.org/cgi/content/full/36/9/e100。并附有每项建议的全文证据表。结论这些建议应平等地应用于所有临床环境中的所有卒中康复患者,而不是仅针对联邦医疗系统的临床问题或资源。