Estrade J-P, Agostini A, Roger V, Dallay D, Blanc B, Cravello L
Service de gynécologie-obstétrique, hôpital Pellegrin, place Amélie-Raba-Léon, 33000 Bordeaux, France.
Gynecol Obstet Fertil. 2004 Oct;32(10):850-4. doi: 10.1016/j.gyobfe.2004.08.018.
To evaluate complications of sacrospinous ligament fixation.
Monocentric retrospective study.
Department of Obstetrics & Gynecology, La Conception University Hospital, Marcella.
Between January 1991 and September 2002, 277 women (mean age 64.9 years, range 37 to 92 years) underwent a sacrospinous ligament fixation; 91% had a menopausal status, and 15.5% used hormone replacement therapy. 33.2% of the patients had prior hysterectomy, 28.9% had a history of surgery for prolapse, and 18.8% had associated symptoms of stress urinary incontinence. In all cases, sacrospinous ligament fixation was performed under visual control using conventional stitch. Sacrospinous ligament fixation was combined with the following procedures: anterior vaginal repair (N =137), additional incontinence surgery (N =31), vaginal hysterectomy (N =137), levator myorraphy (N =203).
Intraoperative complications, postoperative complications, long-term painful symptoms.
Intraoperative complications were represented by 1 case of vascular wound and four rectal injuries. Main postoperative complications were vaginal haematomas (N =6) and abscesses (N =2). Long-term symptoms were perineal pain, sciatic neuralgia, and dyspareunia.
There was no surgical mortality, and we noted low rates of major complications. Sacrospinous ligament fixation assumes high priority in our therapeutic regimen.
评估骶棘韧带固定术的并发症。
单中心回顾性研究。
马赛拉市拉康塞普西翁大学医院妇产科。
1991年1月至2002年9月期间，277名女性（平均年龄64.9岁，范围37至92岁）接受了骶棘韧带固定术；91%处于绝经状态，15.5%使用激素替代疗法。33.2%的患者曾接受过子宫切除术，28.9%有脱垂手术史，18.8%伴有压力性尿失禁症状。所有病例均在直视下采用传统缝线进行骶棘韧带固定术。骶棘韧带固定术联合以下手术：阴道前壁修补术（N = 137）、额外的尿失禁手术（N = 31）、阴道子宫切除术（N = 137）、提肛肌缝合术（N = 203）。
术中并发症、术后并发症、长期疼痛症状。
术中并发症包括1例血管损伤和4例直肠损伤。主要术后并发症为阴道血肿（N = 6）和脓肿（N = 2）。长期症状为会阴疼痛、坐骨神经痛和性交困难。
无手术死亡病例，且主要并发症发生率较低。骶棘韧带固定术在我们的治疗方案中具有高度优先地位。
