South M, Amundsen C L
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA.
Minerva Ginecol. 2007 Dec;59(6):601-12.
Pelvic organ prolapse has afflicted women since the beginning of mankind. Even though we have been faced with this problem for so many centuries, we still have not found a way to overcome gravity and prevent prolapse. We continue to make efforts to manage prolapse, modifying our techniques based on burgeoning research. This knowledge helps us to avoid repetitive complications from surgery and to improve techniques to prevent recurrent prolapse. In addition, we are constantly adapting our methods depending on available technology. With an aging population, the demand for physicians and surgeons trained in management of pelvic organ prolapse will increase. The rapidly evolving literature on pelvic organ prolapse makes a comprehensive review difficult. However, based on the current literature, randomized controlled trials are needed to compare new prolapse repair techniques to traditional techniques. Physicians specializing in surgical management of pelvic organ prolapse will need to work together to complete quality clinical trials. The primary focus of this review will be on the recent research concerning the epidemiology, etiology, presenting symptoms, and diagnosis of pelvic organ prolapse. We will also discuss the different types of prolapse by compartments of the vagina in which they occur and how each of these types of prolapse can be managed. Finally, we will review recent literature evaluating surgical repairs using transvaginal mesh kits.
自人类伊始,盆腔器官脱垂就一直困扰着女性。尽管我们面对这个问题已经有好几个世纪了,但我们仍然没有找到克服重力并预防脱垂的方法。我们继续努力处理脱垂问题,根据不断涌现的研究改进我们的技术。这些知识帮助我们避免手术中反复出现的并发症,并改进预防复发脱垂的技术。此外,我们不断根据现有技术调整方法。随着人口老龄化,对接受盆腔器官脱垂管理培训的内科医生和外科医生的需求将会增加。关于盆腔器官脱垂的文献迅速发展,全面综述变得困难。然而,根据当前文献,需要进行随机对照试验来比较新的脱垂修复技术与传统技术。专门从事盆腔器官脱垂手术管理的医生需要共同努力完成高质量的临床试验。本综述的主要重点将是关于盆腔器官脱垂的流行病学、病因、症状表现和诊断的最新研究。我们还将讨论脱垂发生在阴道不同腔室的不同类型,以及每种类型的脱垂如何处理。最后,我们将综述近期评估使用经阴道网状套件进行手术修复的文献。