Karateke Ates, Gurbuz Ayse, Kabaca Canan, Mengulluoglu Murat
Zeynep Kamil Women's and Children's Diseases, Education and Research Hospital, Istanbul, Turkey.
Med Princ Pract. 2004 May-Jun;13(3):164-8. doi: 10.1159/000076957.
To determine the outcome of sacrocervicopexy and combined operations in the treatment of uterovaginal prolapse in women with desire to preserving both uterus and fertility.
Sacrocervicopexy with Prolene mesh and combined operations were performed in 3 women with total uterine prolapse because of the patient's desire to retain fertility in 2 cases and refusal of hysterectomy in the 3rd patient. The 1st case was a 38-year-old woman, gravida 2, parity 1; the 2nd case a 42-year-old woman, gravida 3, parity 2, and the 3rd a 39-year-old woman, gravida 1, parity 1. Douglas pouch was obliterated with Moschcowitz operation. All of the women underwent sacrocervicopexy with Prolene mesh. The repair of a paravaginal defect and prophylactic Burch urethropexy were accomplished through entering Retzius' space. Genital hiatus was narrowed via approximating levator muscles transvaginally. No serious intraoperative complications occurred and no recurrence was detected during the follow-up period. There was no postoperative complication except for some degree of pain in the 1st postoperative month in 1 case.
The results indicate that sacrocervicopexy and repair of all concomitant defects in the pelvic floor are effective procedures in the treatment of uterovaginal prolapse in cases where there is a desire to retain fertility and uterus.
确定在有保留子宫和生育能力意愿的女性中，骶子宫固定术及联合手术治疗子宫阴道脱垂的效果。
3例子宫完全脱垂的女性接受了聚丙烯网片骶子宫固定术及联合手术，原因是2例患者有保留生育能力的意愿，第3例患者拒绝子宫切除术。第1例为38岁女性，孕2产1；第2例为42岁女性，孕3产2；第3例为39岁女性，孕1产1。采用莫斯考维茨手术封闭Douglas窝。所有女性均接受了聚丙烯网片骶子宫固定术。经进入Retzius间隙完成阴道旁缺损修补及预防性Burch尿道悬吊术。经阴道将提肌拉近使生殖裂孔变窄。术中未发生严重并发症，随访期间未发现复发。除1例在术后第1个月有一定程度的疼痛外，无术后并发症。
结果表明，在有保留生育能力和子宫意愿的病例中，骶子宫固定术及盆底所有伴随缺损的修复是治疗子宫阴道脱垂的有效方法。
