Understanding the mechanics of closure is key to optimal midurethral sling technique
Understanding the mechanics of closure is key to optimal midurethral sling technique
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DOI：
10.1007/s00192-020-04533-9
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发表时间：
2020-09-26
影响因子：
1.8
通讯作者：
Petros, Peter
中科院分区：
文献类型：
--
作者：
Petros, Peter
动物实验和原型尿道吊带手术表明，吊带提供新的胶原蛋白，以加强薄弱的耻骨尿道韧带（PUL）。现在强化的PULs能够恢复3种相反作用的定向闭合力的收缩力。通过收缩，这三种力量在关闭尿道以维持尿失禁时成倍地改变了尿道内对流动的阻力。前向力的放松使两个后向力在逼尿肌收缩之前肆无忌惮地打开尿道后壁，以促进尿液的排出。这项工作的目的是研究有助于这些功能的组成解剖结构的力学，分析细微的细节如何影响尿道中悬吊手术的实际手术技术，以优化成功，促进并发症以及如何预防和修复它们。
The animal experiments and prototype midurethral sling operations demonstrated that the sling provided new collagen to reinforce weak pubourethral ligaments (PUL). The now strengthened PULs were able to restore the contractile power of the 3 oppositely-acting directional closure forces. By contraction, these three forces exponentially altered the intraurethral resistance to flow when they closed the urethra to sustain continence. Relaxation of the forward force allowed the two posterior forces to uninhibitedly open the posterior urethral wall just prior to detrusor contraction, to facilitate evacuation of urine. The aim of this work is to examine the mechanics of the component anatomical structures which contribute to these functions, to analyse how subtle details impact on the actual surgical technique of the midurethral sling operations to optimize success, contribute to complications and how to prevent and fix them.