Barranger Emmanuel, Fritel Xavier, Pigne Alain
Department of Obstetrics and Gynecology, Tenon Hospital, 4 rue de la Chine, 75020 Paris, France.
Am J Obstet Gynecol. 2003 Nov;189(5):1245-50. doi: 10.1067/s0002-9378(03)00665-3.
The purpose of this study was to evaluate the long-term efficiency after abdominal sacrohysteropexy in women with uterovaginal prolapse.
We conducted a retrospective chart review at our tertiary referral urogynecology unit. Thirty women of childbearing age with uterovaginal prolapse who wanted uterine preservation underwent abdominal sacrohysteropexy between 1987 and 1999.
The mean age of the women was 35.7 years (range, 29-43 years). All women were parous. Thirteen women had grade 2 uterovaginal prolapse, and 17 women had grade 3 prolapse. In all women, the Burch procedure and posterior colporrhaphy were performed at the same time. Intraoperative and postoperative complications occurred in 2 patients (6.6%) and 4 patients (13.3%), respectively. The mean objective and subjective follow-up periods were 44.5 months (range, 2-156 months) and 94.6 months (range, 8-160 months), respectively. At the time of the last physical examination, there were two cases of recurrent uterovaginal prolapse (6.6%), which was symptomatic in 1 patient and required repeat surgical treatment. At the time of the last questionnaire, apart from the patient who underwent repeat surgery, no patients had any uterovaginal prolapse symptoms. Three women had pregnancies that were conceived spontaneously, which led to three early legal abortions.
The abdominal sacrohysteropexy is effective and safe in the treatment of uterovaginal prolapse in women of childbearing age. This procedure has a high success rate in correcting prolapse without a time-dependent decrease in efficiency.
本研究旨在评估子宫阴道脱垂女性行腹式骶骨子宫固定术后的长期疗效。
我们在三级转诊泌尿妇科单位进行了一项回顾性病历审查。1987年至1999年间，30名有子宫阴道脱垂且希望保留子宫的育龄妇女接受了腹式骶骨子宫固定术。
这些女性的平均年龄为35.7岁（范围29 - 43岁）。所有女性均经产。13名女性有2级子宫阴道脱垂，17名女性有3级脱垂。所有女性均同时进行了Burch手术和阴道后壁修补术。术中及术后并发症分别发生在2例（6.6%）和4例（13.3%）患者中。客观随访期和主观随访期的平均时间分别为44.5个月（范围2 - 156个月）和94.6个月（范围8 - 160个月）。在最后一次体格检查时，有2例复发性子宫阴道脱垂（6.6%），其中1例有症状，需要再次手术治疗。在最后一次问卷调查时，除了接受再次手术的患者外，没有患者有任何子宫阴道脱垂症状。3名女性自然受孕，导致3次早期人工流产。
腹式骶骨子宫固定术治疗育龄期女性子宫阴道脱垂有效且安全。该手术在纠正脱垂方面成功率高，且疗效不会随时间下降。
