Mølsted-Pedersen Lars, Rudnicki Martin, Lose Gunnar
Department of Obstetrics and Gynecology, Copenhagen County Hospital Glostrup, Denmark.
Acta Obstet Gynecol Scand. 2006;85(7):874-8. doi: 10.1080/00016340500342052.
The aim was to describe the operative technique of transvaginal repair of enterocele and apical prolapse using autologous fascia lata and report intra- and postoperative complications and long-term outcome.
A retrospective chart review of 74 consecutive patients who had repair of a symptomatic enterocele and vaginal vault prolapse or uterine prolapse from January 1987 to August 1999. All patients were followed for a minimum of 3 months and 61 were available for long-term evaluation at 18-106 months (median 52 months).
Intra- and postoperative complications were few. Pelvic examination at long-term follow-up disclosed a recurrence rate for enterocele of 1.7%, vaginal vault prolapse of 8.3%, and cystocele of 15%. Ninety-one per cent were subjectively satisfied with the relief of mechanical vaginal symptoms. Only 35% (6/17) were cured of constipation. Out of the 22 women who were sexually active after the procedure, 12 (54%) experienced improved quality.
Repair of the posterior compartment defect and suspension of the vaginal vault using autologous fascia lata graft provides acceptable intra- and postoperative complication and long-term results.
目的是描述使用自体阔筋膜经阴道修复肠膨出和顶端脱垂的手术技术,并报告术中和术后并发症及长期疗效。
对1987年1月至1999年8月期间连续74例有症状性肠膨出、阴道穹窿脱垂或子宫脱垂进行修复的患者进行回顾性病历审查。所有患者至少随访3个月,61例患者在18至106个月(中位数52个月)时接受长期评估。
术中和术后并发症较少。长期随访的盆腔检查显示,肠膨出复发率为1.7%,阴道穹窿脱垂为8.3%,膀胱膨出为15%。91%的患者对机械性阴道症状的缓解主观上感到满意。只有35%(6/17)的便秘患者治愈。在术后仍有性生活的22名女性中,12名(54%)性生活质量得到改善。
使用自体阔筋膜移植修复后盆腔缺陷和悬吊阴道穹窿可获得可接受的术中和术后并发症及长期效果。