Reddy K, Malik T G
Department of Obstetrics and Gynaecology, Prince Charles Hospital, Merthyr Tydfil, South Wales, UK.
J Obstet Gynaecol. 2002 Sep;22(5):532-6. doi: 10.1080/0144361021000003708.
The aim of this study was to evaluate the short-term and long-term outcome with patients' satisfaction of abdominal sacrocolpopexy performed on our initial 11 patients for vaginal vault prolapse. All patients included in this study underwent surgery at a district general hospital and was performed by one experienced clinician (co-author). A retrospective analysis was performed on all 11 consecutive women who underwent abdominal sacrocolpopexy for vaginal vault prolapse between September 1996 and January 1997 and were followed-up at 6 months and at 5-year intervals. Our initial experience reveals that abdominal sacrocolpopexy is a safe and effective method in the treatment of posthysterectomy prolapse of the vaginal vault. It is associated with a low incidence of intraoperative and immediate postoperative complications and recurrent vault prolapse. Latent stress incontinence may be unmasked and preoperative urodynamic evaluation is therefore recommended. Our study also agrees with the other studies in that co-existent cystocoele, rectocoele and enterocoele should be corrected at the same setting. Following this series we have modified our technique to reduce postoperative complications such as graft erosion, which is being analysed separately. It finally concludes that this operation should be considered by every gynaecologist and that it can be performed in any district general hospital.
本研究旨在评估对我院最初11例阴道穹窿脱垂患者实施腹骶阴道固定术的短期和长期疗效以及患者满意度。本研究纳入的所有患者均在一家区综合医院接受手术,且由一位经验丰富的临床医生(共同作者)实施。对1996年9月至1997年1月期间连续接受腹骶阴道固定术治疗阴道穹窿脱垂的11名女性进行回顾性分析,并分别在术后6个月和每5年进行随访。我们最初的经验表明,腹骶阴道固定术是治疗子宫切除术后阴道穹窿脱垂的一种安全有效的方法。它与术中及术后即刻并发症和复发性穹窿脱垂的发生率较低相关。潜在的压力性尿失禁可能会被发现,因此建议进行术前尿动力学评估。我们的研究还与其他研究一致,即并存的膀胱膨出、直肠膨出和肠膨出应在同一手术中予以纠正。在这一系列病例之后,我们改进了技术以减少诸如移植物侵蚀等术后并发症,相关分析正在单独进行。最终得出结论,每位妇科医生都应考虑开展此手术,并且它可以在任何区综合医院进行。