Brizzolara Shawna, Pillai-Allen Anita
John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96826, USA.
Obstet Gynecol. 2003 Aug;102(2):306-10. doi: 10.1016/s0029-7844(03)00515-5.
To examine short- and long-term mesh-related complications in women undergoing abdominal sacral colpopexy with concurrent hysterectomy, compared with women with a prior hysterectomy undergoing sacral colpopexy alone.
Patient characteristics, hospital complications, postoperative clinical course, and long-term graft-related complications were reviewed for all women with genital prolapse who underwent abdominal sacral colopexy between 1996 and 1998. Women with concurrent hysterectomy were compared with women with vaginal prolapse after a prior hysterectomy.
One hundred twenty-four patients, 60 with concurrent hysterectomy and 64 with prior hysterectomy, were observed postoperatively for a median of 35.5 (0-74) months. Demographics of the two groups were similar, with a mean age of 65.1 +/- 9.4 years and a mean body mass index of 25.8 +/- 4.2 kg/m(2). Eighty percent of colpopexies used prolene synthetic mesh and 20% allograft material. Initial operative and hospital complications were rare in both groups and included a blood transfusion of 2 U, a ureteral transection, a wound infection, heart block, and an arrhythmia. Delayed graft complications included one mesh erosion in a patient with a prior hysterectomy that was managed by office resection (0.8%).
Concurrent hysterectomy with abdominal sacral colopopexy has a low incidence of mesh complications and can be used as a first-line treatment for genital prolapse.
比较接受腹骶阴道固定术同时行子宫切除术的女性与先前已行子宫切除术、仅接受骶骨阴道固定术的女性中，与补片相关的短期和长期并发症。
回顾了1996年至1998年间所有接受腹骶阴道固定术治疗生殖器脱垂女性的患者特征、医院并发症、术后临床病程及长期与移植物相关的并发症。将同时行子宫切除术的女性与先前子宫切除术后出现阴道脱垂的女性进行比较。
124例患者术后接受了中位时间为35.5（0 - 74）个月的观察，其中60例同时行子宫切除术，64例先前已行子宫切除术。两组人口统计学特征相似，平均年龄为65.1±9.4岁，平均体重指数为25.8±4.2kg/m²。80%的阴道固定术使用普理灵合成补片，20%使用同种异体移植物材料。两组的初始手术和医院并发症均罕见，包括2单位输血、输尿管横断、伤口感染、心脏传导阻滞和心律失常。延迟性移植物并发症包括1例先前已行子宫切除术患者的补片侵蚀，通过门诊切除处理（0.8%）。
腹骶阴道固定术同时行子宫切除术的补片并发症发生率低，可作为生殖器脱垂的一线治疗方法。
