骶棘韧带子宫固定术和经阴道子宫切除术治疗子宫脱垂的一年随访：一项随机研究
One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study.
作者信息
Dietz Viviane, van der Vaart Carl H, van der Graaf Yolanda, Heintz Peter, Schraffordt Koops Steven E
机构信息
Department of Obstetrics and Gynecology, Catharina Medical Center, Michelangelolaan 2, 5623, Eindhoven, The Netherlands.
出版信息
Int Urogynecol J. 2010 Feb;21(2):209-16. doi: 10.1007/s00192-009-1014-7. Epub 2009 Oct 16.
INTRODUCTION AND HYPOTHESIS
In a retrospective study, the sacrospinous hysteropexy was associated with a shorter recovery time compared to a vaginal hysterectomy with no differences in anatomical outcomes. No randomized trials are performed.
METHODS
Sixty-six women with stage 2-4 uterine descent were randomized for vaginal hysterectomy(31) or sacrospinous hysteropexy(35). Recovery time, anatomical outcomes, functional outcomes, and quality of life were measured.
RESULTS
Length of time to return to work was shorter after a sacrospinous hysteropexy (43 versus 66 days, p = 0.02). The difference in risk for recurrent prolapse stage 2 or more of the apical compartment at 1-year follow-up was 17% (95% confidence interval, 2 to 30) in favor of the vaginal hysterectomy. No differences in quality of life and urogenital symptoms were found.
CONCLUSIONS
The sacrospinous hysteropexy for uterine descent is associated with an earlier recovery time, more recurrent apical prolapses but no differences in functional outcomes, and quality of life.
引言与假设
在一项回顾性研究中，与经阴道子宫切除术相比，骶棘韧带子宫固定术恢复时间更短，解剖学结果无差异。未进行随机试验。
方法
将66例2 - 4期子宫脱垂的女性随机分为经阴道子宫切除术组（31例）或骶棘韧带子宫固定术组（35例）。测量恢复时间、解剖学结果、功能结果和生活质量。
结果
骶棘韧带子宫固定术后恢复工作的时间更短（43天对66天，p = 0.02）。在1年随访时，阴道顶端间隔2期或更严重的复发脱垂风险差异为17%（95%置信区间，2%至30%），经阴道子宫切除术更具优势。生活质量和泌尿生殖系统症状方面未发现差异。
结论
用于子宫脱垂的骶棘韧带子宫固定术恢复时间更早，顶端复发脱垂更多，但功能结果和生活质量无差异。
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