Fox S D, Stanton S L
Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, UK.
BJOG. 2000 Nov;107(11):1371-5. doi: 10.1111/j.1471-0528.2000.tb11650.x.
To assess the sacrocolpopexy with mesh interposition in women with pelvic organ prolapse.
A prospective study.
Tertiary referral urogynaecology and pelvic floor reconstruction unit.
Twenty-nine consecutive women with symptomatic vault prolapse and rectocele.
Subjective and objective success rates and complications.
The mean age was 57 years. The mean number of past prolapse operations was 2.6 which included two past sacrospinous ligament fixations and 17 past posterior repairs. The mean follow up was 14 months. There was an increase in constipation from 41% to 50%, a decrease in faecal soiling from 21% to 10%, and an increase in incomplete defecation from 24% to 36% . Dyspareunia decreased from 38% to 17%, and there was some improvement in the stress and urge incontinence. There was a significant reduction of vault prolapse and rectocele (P < 0.001). All women with Stage II and Stage III vault prolapse were corrected, with an increase in Stage I prolapse from 20% to 27%. All women with Stage II and Stage III rectocele were corrected with a decrease in Stage I prolapse from 36% to 7% . The only significant interoperative complication was a cystotomy. One mesh became infected post-operatively which required removal.
Sacrocolpopexy and mesh interposition is a safe and reliable operation for the correction of vault prolapse and rectocele. A long term follow up is necessary to detect any late complications.
评估采用网片植入的骶骨阴道固定术治疗盆腔器官脱垂的女性患者。
一项前瞻性研究。
三级转诊泌尿妇科及盆底重建科室。
29例连续入选的有症状的穹隆脱垂和直肠膨出女性患者。
主观及客观成功率和并发症。
平均年龄57岁。既往脱垂手术的平均次数为2.6次，其中包括2次既往骶棘韧带固定术和17次既往后路修补术。平均随访时间为14个月。便秘发生率从41%增至50%，粪便污染发生率从21%降至10%，排便不尽发生率从24%增至36%。性交困难从38%降至17%，压力性尿失禁和急迫性尿失禁也有一定改善。穹隆脱垂和直肠膨出明显减轻（P<0.001）。所有Ⅱ期和Ⅲ期穹隆脱垂的女性患者均得到矫正，Ⅰ期脱垂从20%增至27%。所有Ⅱ期和Ⅲ期直肠膨出的女性患者均得到矫正，Ⅰ期脱垂从36%降至7%。唯一显著的术中并发症是膀胱切开术。1例网片术后感染，需取出。
骶骨阴道固定术及网片植入是矫正穹隆脱垂和直肠膨出的一种安全可靠的手术。需要长期随访以发现任何晚期并发症。
