Cheng Jia-jing, Zhang Yi, Wu Yi, Gao Tian, Tong Xiao-wen
Department of Obstetrics and Gynecology, Tenth People's Hospital of Shanghai, Shanghai Tongji University, China.
Zhonghua Fu Chan Ke Za Zhi. 2005 Mar;40(3):148-50.
To explore the feasibility and effectiveness of a modified posterior vaginal wall hammock (PVWH) in the treatment of female pelvic organ prolapse without removal of uterus.
Thirty-two patients with different defects of pelvic organ prolapse underwent a modified PVWH. The procedures included restoring the position of prolapsed uterus by suturing polypropylene mesh to bilateral sacro-spinous ligaments, strengthening utero-sacral ligament by intra-vaginal slingplasty (Tyco Healthcare Group), forming a new recto-vaginal fascia and strengthening levator ani muscle.
The average operating time was 55 minutes and hemorrhage was 150 ml respectively. Recovery of uterine prolapse was achieved in all cases. After an average follow up of seven months, no vagina distortion, shortening and dyspareunia were observed. One patient had uterine cervix elongation three months after operation. The relieving rate of subjective symptoms was more than 50%.
Female uterine prolapse could be cured by the modified PVWH and the uterus could be successfully reserved during pelvic floor reconstruction with promising short-term results. More clinical trials are needed to evaluate its effectiveness, safety and long-term outcome.
探讨改良阴道后壁吊带术（PVWH）在不切除子宫的情况下治疗女性盆腔器官脱垂的可行性和有效性。
32例不同程度盆腔器官脱垂患者接受改良PVWH手术。手术步骤包括通过将聚丙烯网片缝合至双侧骶棘韧带恢复脱垂子宫的位置，经阴道吊带成形术（泰科医疗集团）加强子宫骶韧带，形成新的直肠阴道筋膜并加强肛提肌。
平均手术时间为55分钟，平均出血量为150毫升。所有病例子宫脱垂均得到恢复。平均随访7个月后，未观察到阴道变形、缩短及性交困难。1例患者术后3个月出现宫颈延长。主观症状缓解率超过50%。
改良PVWH可治愈女性子宫脱垂，在盆底重建过程中可成功保留子宫，短期效果良好。需要更多的临床试验来评估其有效性、安全性和长期疗效。
