骶骨阴道固定术后1年女性的肠道症状

Bowel symptoms in women 1 year after sacrocolpopexy.

作者信息

Bradley Catherine S, Nygaard Ingrid E, Brown Morton B, Gutman Robert E, Kenton Kimberly S, Whitehead William E, Goode Patricia S, Wren Patricia A, Ghetti Chiara, Weber Anne M

机构信息

Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

出版信息

Am J Obstet Gynecol. 2007 Dec;197(6):642.e1-8. doi: 10.1016/j.ajog.2007.08.023.

DOI:10.1016/j.ajog.2007.08.023

PMID:18060963

Abstract

OBJECTIVE

The objective of the study was to evaluate changes in bowel symptoms after sacrocolpopexy.

STUDY DESIGN

This was a prospectively planned, ancillary analysis of the Colpopexy and Urinary Reduction Efforts study, a randomized trial of sacrocolpopexy with or without Burch colposuspension in stress continent women with stages II-IV prolapse. In addition to sacrocolpopexy (+/- Burch), subjects underwent posterior vaginal or perineal procedures (PR) at each surgeon's discretion. The preoperative and 1 year postoperative Colorectal-anal Distress Inventory (CRADI) scores were compared within and between groups using Wilcoxon signed-rank and rank-sum tests, respectively.

RESULTS

The sacrocolpopexy + PR group (n = 87) had more baseline obstructive colorectal symptoms (higher CRADI and CRADI-obstructive scores: P = .04 and < .01, respectively) than the sacrocolpopexy alone group (n = 211). CRADI total, obstructive, and pain/irritation scores significantly improved in both groups (all P < .01). Most bothersome symptoms resolved after surgery in both groups.

CONCLUSION

Most bowel symptoms improve in women with moderate to severe pelvic organ prolapse after sacrocolpopexy.

摘要

目的

本研究的目的是评估骶骨阴道固定术后肠道症状的变化。

研究设计

这是一项前瞻性规划的对阴道骶骨固定术和减少尿失禁研究的辅助分析，该研究是一项针对II-IV期脱垂的压力性尿失禁女性进行的随机试验，比较骶骨阴道固定术联合或不联合Burch阴道悬吊术的效果。除了骶骨阴道固定术（±Burch术）外，每位外科医生可自行决定让受试者接受阴道后壁或会阴手术（PR）。分别使用Wilcoxon符号秩和检验与秩和检验对术前和术后1年的结直肠肛门困扰量表（CRADI）评分在组内和组间进行比较。

结果

骶骨阴道固定术+PR组（n = 87）比单纯骶骨阴道固定术组（n = 211）有更多的基线阻塞性结直肠症状（CRADI和CRADI阻塞性评分更高：分别为P = 0.04和<0.01）。两组的CRADI总分、阻塞性评分和疼痛/刺激评分均显著改善（所有P < 0.01）。两组中大多数最困扰的症状在术后都得到了解决。