盆腔重建手术中经阴道放置网片的并发症。
Complications from vaginally placed mesh in pelvic reconstructive surgery.
作者信息
Blandon Roberta E, Gebhart John B, Trabuco Emanuel C, Klingele Christopher J
机构信息
Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
出版信息
Int Urogynecol J Pelvic Floor Dysfunct. 2009 May;20(5):523-31. doi: 10.1007/s00192-009-0818-9. Epub 2009 Feb 10.
INTRODUCTION AND HYPOTHESIS
We describe complications associated with the use of transvaginal mesh for treatment of pelvic organ prolapse.
METHODS
We retrospectively identified patients referred to our institution from January 2003 through September 2007 who had complications after vaginal placement of mesh.
RESULTS
We identified 21 patients with a mean (SD) age of 61 (11) years. Types of mesh used included mesh kits (n = 9, 43%), nontrocar mesh augmentation (n = 5, 24%), IVS Tunneller (n = 4, 19%), and unspecified (n = 3, 14%). Eleven patients (52%) underwent more than one procedure before referral. Only three patients were referred by the original treating surgeon. Complications included mesh erosions in 12 women, dyspareunia in ten, and recurrent prolapse in nine. Sixteen patients (76%) were managed surgically. Follow-up survey among sexually active patients showed 50% with persistent dyspareunia.
CONCLUSIONS
Use of vaginal mesh for pelvic reconstruction can produce complications. Multiple interventions may be necessary, and bothersome symptoms may persist.
引言与假设
我们描述了经阴道网片用于治疗盆腔器官脱垂相关的并发症。
方法
我们回顾性地确定了2003年1月至2007年9月转诊至我院的患者，这些患者在阴道置入网片后出现了并发症。
结果
我们确定了21例患者，平均（标准差）年龄为61（11）岁。使用的网片类型包括网片套件（n = 9，43%）、非套管针网片增强术（n = 5，24%）、IVS隧道器（n = 4，19%）以及未明确类型（n = 3，14%）。11例患者（52%）在转诊前接受了不止一次手术。只有3例患者是由最初的治疗外科医生转诊的。并发症包括12名女性出现网片侵蚀、10名出现性交困难、9名出现复发脱垂。16例患者（76%）接受了手术治疗。对有性生活的患者进行随访调查显示，50%的患者持续性交困难。
结论
使用阴道网片进行盆腔重建可能会产生并发症。可能需要多次干预，且令人烦恼的症状可能会持续存在。
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