Miedel Ann, Tegerstedt Gunilla, Mörlin Birgitta, Hammarström Margareta
Department of Clinical Science and Education, Södersjukhuset, Section of Obstetrics and Gynaecology, Karolinska Institutet, 118 83, Stockholm, Sweden.
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Dec;19(12):1593-601. doi: 10.1007/s00192-008-0702-z. Epub 2008 Aug 12.
The objective of this study was to evaluate anatomic, functional, short- and long-term outcome of vaginal surgery for pelvic organ prolapse. This was a prospective observational study of 185 consecutive women planned for vaginal prolapse reconstructive surgery. Stage of prolapse, urinary incontinence (UI), bowel and mechanical symptoms were assessed preoperatively and at 1, 3 and 5 years postoperatively. The mean follow-up time was 53 months. The anatomic recurrence rate was 41.1% but less than half of them were symptomatic. Anterior compartment was most prone for recurrence and the majority of the recurrences took place within the first year. UI remained at the same level at 1-year follow-up. De novo urge occurred in 22.6% and de novo stress incontinence in 6.0%. An improvement was seen in difficulty in emptying bowel 1 year after surgery (54%). Patients were primarily cured from mechanical symptoms. Re-operation rate was 9.7%; if additional operation for incontinence was included, it was13.5%.
本研究的目的是评估盆腔器官脱垂阴道手术的解剖学、功能、短期和长期结果。这是一项对185例计划进行阴道脱垂重建手术的连续女性患者的前瞻性观察研究。术前及术后1年、3年和5年评估脱垂程度、尿失禁（UI）、肠道及机械性症状。平均随访时间为53个月。解剖学复发率为41.1%，但其中不到一半有症状。前盆腔最易复发，且大多数复发发生在第一年。1年随访时尿失禁情况维持不变。新发性急迫性尿失禁发生率为22.6%，新发性压力性尿失禁发生率为6.0%。术后1年排便困难情况有所改善（54%）。患者的机械性症状基本治愈。再次手术率为9.7%；若包括因尿失禁进行的额外手术，则为13.5%。
