Limb Jerry, Wood Kay, Weinberger Michael, Miyazaki Fred, Aboseif Sherif
Department of Urology, Southern California Permanente Medical Group, Kaiser Permanente Medical Center, 4900 Sunset Boulevard, 2nd Floor, Los Angeles, CA 90027, USA.
World J Urol. 2005 Feb;23(1):55-60. doi: 10.1007/s00345-004-0457-1. Epub 2004 Nov 11.
We report the efficacy and safety of abdominal sacral colpopexy using Mersilene mesh to treat vaginal vault prolapse. A total of 61 patients underwent sacral colpopexy to treat vaginal vault prolapse of whom 58 were available for evaluation. The procedure utilizes an abdominal approach to expose the vaginal vault and the anterior surface of the first and second sacral vertebrae. A Mersilene mesh is fastened to the anterior and posterior vaginal walls then anchored to the sacrum without tension. Hysterectomy and posterior colporrhaphy were performed as indicated. Concomitant anti-incontinence surgery was performed in 52 patients: 41 underwent Burch colposuspension, and 11 had pubovaginal sling placement. To assess long-term subjective and clinical efficacy, patients completed a questionnaire and underwent pelvic examination at least 1 year following surgery. The resolution of symptoms, objective restoration of normal pelvic support, and urinary continence defined surgical success. Median patient age at operation was 62 years. Previous operations included 29 hysterectomy procedures, five failed sacrospinous fixation, and 12 failed anti-incontinence procedures. The total complication rate was 15%. With a median follow-up of 26 months, complete correction of vaginal prolapse was found in 91% of patients. Vaginal symptoms were relieved in 90% of patients and 88% of patients had resolution of their urinary incontinence. Ninety percent of patients were satisfied with the surgery and would recommend it to others. Sacral colpopexy using Mersilene mesh relieves vaginal vault symptoms, restores vaginal function, and provides durable pelvic support.
我们报告了使用Mersilene网片行腹骶阴道固定术治疗阴道穹窿脱垂的疗效和安全性。共有61例患者接受了骶阴道固定术以治疗阴道穹窿脱垂，其中58例可供评估。该手术采用腹部入路暴露阴道穹窿以及第一和第二骶椎的前表面。将Mersilene网片固定于阴道前壁和后壁，然后无张力地锚定在骶骨上。根据需要进行子宫切除术和阴道后壁修补术。52例患者同时进行了抗尿失禁手术：41例行Burch阴道悬吊术，11例行耻骨后阴道吊带置入术。为评估长期主观和临床疗效，患者在术后至少1年完成问卷调查并接受盆腔检查。症状缓解、盆腔支持结构客观恢复正常以及尿失禁得到控制定义为手术成功。手术时患者的中位年龄为62岁。既往手术包括29例子宫切除术、5例骶棘韧带固定术失败以及12例抗尿失禁手术失败。总并发症发生率为15%。中位随访26个月时，91%的患者阴道脱垂得到完全纠正。90%的患者阴道症状得到缓解，88%的患者尿失禁症状得到解决。90%的患者对手术满意并会向他人推荐。使用Mersilene网片的骶阴道固定术可缓解阴道穹窿症状，恢复阴道功能，并提供持久的盆腔支持。
