Botros Sylvia M, Sand Peter K, Beaumont Jennifer L, Abramov Yoram, Miller Jay James, Goldberg Roger P
Evanston Northwestern Healthcare, Division of Urogynecology, Feinberg School of Medicine, Northwestern University, Suite 730, Evanston, IL 60201, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Oct;20(10):1265-71. doi: 10.1007/s00192-009-0933-7. Epub 2009 Jun 17.
The aim of this study is to compare acellular dermal matrix to standard colporrhaphy for cystocele repair.
One hundred two patients with greater than or equal to stage II anterior prolapse (Aa or Ba 0) who underwent anterior colporrhaphy with acellular dermal implant attached to the arcus between October 2003 and February 2007 were compared to 89 controls who received standard anterior colporrhaphy. Objective recurrence was defined as greater than or equal to stage II (Aa or Ba -1).
The dermal graft and colporrhaphy groups were comparable in age, parity, body mass index, and concomitant surgeries except hysteropexy and hysterectomy. Regression was performed for possible confounders. Postoperatively, 14 (19%) recurrences were identified in the dermal graft group vs. 26 (43%) in the colporrhaphy group (p = 0.004). Two patients underwent reoperations for cystocele recurrence in the study group vs. four in the control group. Time to normal voiding, subjective stress urinary incontinence, estimated blood loss, and length of hospital stay did not differ between groups.
Dermal acellular matrix provides benefit over standard colporrhaphy.
本研究旨在比较脱细胞真皮基质与标准阴道修补术用于膀胱膨出修复的效果。
将2003年10月至2007年2月间接受了在耻骨弓处附着脱细胞真皮植入物的前路阴道修补术的102例II期及以上前壁脱垂（Aa或Ba 0）患者，与89例接受标准前路阴道修补术的对照组患者进行比较。客观复发定义为II期及以上（Aa或Ba -1）。
除子宫固定术和子宫切除术外，真皮移植组和阴道修补术组在年龄、产次、体重指数及同期手术方面具有可比性。对可能的混杂因素进行了回归分析。术后，真皮移植组有14例（19%）复发，而阴道修补术组有26例（43%）复发（p = 0.004）。研究组有2例患者因膀胱膨出复发接受了再次手术，对照组有4例。两组在排尿恢复正常的时间、主观压力性尿失禁、估计失血量及住院时间方面无差异。
脱细胞真皮基质在膀胱膨出修复方面比标准阴道修补术更具优势。
