泌尿生殖系统脱垂的闭塞性和重建性阴道手术后新发直肠脱垂

De novo rectal prolapse after obliterative and reconstructive vaginal surgery for urogenital prolapse.

作者信息

Collins Sarah A, Jelovsek J Eric, Chen Chi Chiung Grace, Gustilo-Ashby A Marcus, Barber Matthew D

机构信息

Section of Urogynecology and Reconstructive Pelvic Surgery, Division of Surgery, Department of Gynecology and Obstetrics, Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

Am J Obstet Gynecol. 2007 Jul;197(1):84.e1-3. doi: 10.1016/j.ajog.2007.02.050.

DOI:10.1016/j.ajog.2007.02.050

PMID:17618769

Abstract

OBJECTIVE

The purpose of this study was to compare the incidence of de novo rectal prolapse after obliterative vaginal surgery with the incidence that was seen after reconstructive vaginal surgery for urogenital prolapse.

STUDY DESIGN

A chart review was performed on subjects who underwent vaginal surgery for urogenital prolapse from Jan. 1, 2001, through Dec. 31, 2004, at the Cleveland Clinic. Diagnosis of postoperative rectal prolapse was identified with ICD-9 code 569.1.

RESULTS

Nine hundred sixteen women underwent vaginal surgery for urogenital prolapse. Ninety-two percent of the women (n = 840) underwent reconstructive surgery, and 8% of the women (n = 76) underwent obliterative surgery. The incidence of postoperative full-thickness rectal prolapse in women who were > or = 65 years old who underwent obliterative surgery was 3 of 74 (4.1%; 95% CI, 1.4-11), with an estimated odds ratio of 22 (95% CI, 2.3-196; P < .002) compared with women who were > or = 65 years old who underwent reconstructive surgery.

CONCLUSION

Obliterative surgery is associated with a substantially greater risk of de novo rectal prolapse than reconstructive vaginal surgery for urogenital prolapse.

摘要

目的

本研究旨在比较泌尿生殖系统脱垂的闭塞性阴道手术后直肠脱垂的发生率与重建性阴道手术后直肠脱垂的发生率。

研究设计

对2001年1月1日至2004年12月31日在克利夫兰诊所接受泌尿生殖系统脱垂阴道手术的患者进行病历回顾。术后直肠脱垂的诊断通过ICD-9编码569.1确定。

结果

916名女性接受了泌尿生殖系统脱垂的阴道手术。其中92%（n = 840）的女性接受了重建性手术，8%（n = 76）的女性接受了闭塞性手术。年龄≥65岁且接受闭塞性手术的女性术后全层直肠脱垂的发生率为74例中有3例（4.1%；95%置信区间，1.4 - 11），与年龄≥65岁且接受重建性手术的女性相比，估计优势比为22（95%置信区间，2.3 - 196；P <.002）。