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经阴道骶骨直肠固定术治疗直肠脱垂:技术与结果

Repair of prolapse with vaginal sacrocolporectopexy: technique and results.

作者信息

Kavallaris Andreas, Köhler Christhardt, Diebolder Herbert, Vercellino Filiberto, Krause Norman, Schneider Achim

机构信息

Department of Gynecology, Friedrich Schiller University, Jena, Germany.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2005 Oct 1;122(2):237-42. doi: 10.1016/j.ejogrb.2005.01.020. Epub 2005 Jun 9.

Abstract

OBJECTIVE

Axis and support of the vagina can be restored by sacrocolporectopexy with preservation of coital function. We developed a new technique of transvaginal sacrocolporectopexy for patients with prolapse of uterus and vagina or prolapse of the vaginal vault.

STUDY DESIGN

During a 4-year period, 20 patients with vaginal vault prolapse and 83 patients with uterine and vaginal prolapse underwent transvaginal sacrocolporectopexy. Intra- and postoperative complications were recorded. After a mean follow-up period of 24 months (6-48), the result of surgery with respect to prolapse, incontinence, and sexuality was evaluated by patient interviews.

RESULTS

No serious perioperative complications occurred with the exception of one patient with bleeding from a presacral vein. Subjectively, 84 patients (82%) were cured of prolapse symptoms. One patient had recurrent grade II vault prolapse and four patients developed a grade II rectocele. Five patients developed urge incontinence grade I. One patient developed fecal incontinence. No patient had coital problems as a sequelae of sacrocolporectopexy.

CONCLUSION

Transvaginal sacrocolporectopexy is a safe procedure with a success rate comparable to sacrospinous fixation.

摘要

目的

通过保留性交功能的骶骨直肠固定术恢复阴道轴和支撑。我们为子宫和阴道脱垂或阴道穹窿脱垂患者开发了一种经阴道骶骨直肠固定术的新技术。

研究设计

在4年期间,20例阴道穹窿脱垂患者和83例子宫及阴道脱垂患者接受了经阴道骶骨直肠固定术。记录术中及术后并发症。平均随访24个月(6 - 48个月)后,通过患者访谈评估手术在脱垂、尿失禁和性功能方面的结果。

结果

除1例患者骶前静脉出血外,未发生严重围手术期并发症。主观上,84例患者(82%)脱垂症状治愈。1例患者出现复发性II度穹窿脱垂,4例患者出现II度直肠膨出。5例患者出现I度急迫性尿失禁。1例患者出现大便失禁。没有患者因骶骨直肠固定术出现性交问题。

结论

经阴道骶骨直肠固定术是一种安全的手术,成功率与骶棘肌固定术相当。

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