腹骶阴道固定术或阴道骶棘韧带固定术治疗阴道穹窿脱垂：一项前瞻性随机研究。
Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study.
作者信息
Maher Christopher F, Qatawneh Aymen M, Dwyer Peter L, Carey Marcus P, Cornish Ann, Schluter Philip J
机构信息
Urogynaecology Unit, Royal Women's and Mater Hospitals, Brisbane, QLD, Australia.
出版信息
Am J Obstet Gynecol. 2004 Jan;190(1):20-6. doi: 10.1016/j.ajog.2003.08.031.
OBJECTIVE
The purpose of this study was to compare the abdominal sacral colpopexy and vaginal sacrospinous colpopexy in the treatment of vaginal vault prolapse.
STUDY DESIGN
Ninety-five women with vaginal vault prolapse were allocated randomly to sacral colpopexy (47 women) or sacrospinous colpopexy (48 women). Primary outcome measurements include subjective, objective, and patient-determined success rates. Secondary outcomes include the impact on bowel, bladder, and sexual function, cost, and quality of life.
RESULTS
Two years after the operation (range, 6-60 months), the subjective success rate was 94% in the abdominal and 91% in the vaginal group (P=.19). The objective success rate was 76% in the abdominal group and 69% in the vaginal group (P=.48). The abdominal approach was associated with a longer operating time, a slower return to activities of daily living, and a greater cost than the sacrospinous colpopexy (P<.01). Both surgeries significantly improved the patient's quality of life (P<.05).
CONCLUSION
Abdominal sacral colpopexy and vaginal sacrospinous colpopexy are both highly effective in the treatment of vaginal vault prolapse.
目的
本研究旨在比较腹骶阴道固定术和阴道骶棘韧带固定术治疗阴道穹窿脱垂的效果。
研究设计
95例阴道穹窿脱垂患者被随机分为骶前阴道固定术组（47例）和骶棘韧带固定术组（48例）。主要结局指标包括主观、客观和患者自评成功率。次要结局包括对肠道、膀胱和性功能的影响、费用及生活质量。
结果
术后两年（范围6 - 60个月），腹骶阴道固定术组主观成功率为94%，阴道骶棘韧带固定术组为91%（P = 0.19）。腹骶阴道固定术组客观成功率为76%，阴道骶棘韧带固定术组为69%（P = 0.48）。与骶棘韧带固定术相比，腹骶阴道固定术手术时间更长，恢复日常生活活动较慢，费用更高（P < 0.01）。两种手术均显著改善了患者的生活质量（P < 0.05）。
结论
腹骶阴道固定术和阴道骶棘韧带固定术治疗阴道穹窿脱垂均非常有效。
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