Department of Obstetrics and Gynaecology, Amphia Hospital, Breda, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 2010 Mar;149(1):112-6. doi: 10.1016/j.ejogrb.2009.12.006. Epub 2009 Dec 31.
To evaluate factors influencing pelvic organ prolapse (POP) recurrence after repair surgery with a porcine dermal collagen implant (Pelvicol).
From December 2003 to August 2005, 78 patients with mainly stage 3 pelvic organ prolapse by the Pelvic Organ Prolapse Quantification (POP-Q) system underwent vaginal repair using porcine dermal implant. Assessments were made preoperatively and at 6 weeks and one year follow-up. These included physical examination with POP-Q, Incontinence Impact Questionnaire, Urogenital Distress Inventory and the Defaecatory Distress Inventory and questions from the Patient Global Impression of Improvement. Data were recorded on changes in functional status, mesh erosion and adverse events. Procedural success was defined as POP-Q stage 0/1.
71 patients returned for one year follow-up. The overall cure rate was 74.6%. The chance of a successful operation in the younger group was significantly higher than in the older group (OR: 7.5; 95% CI 1.38, 40.69), but this effect is lower and no longer significant after adjusting for compartment (post, anterior, post+anterior) (adjusted OR: 5.5; 95% CI 0.92, 32.6).
A low complication rate and satisfactory overall results were observed in a group of women after POP repair surgery with Pelvicol. Whether these results are better or worse than with conventional surgery or non-resorbable mesh implantation is unclear and can only be determined in a randomized controlled trial. There was a strong tendency towards better results in the younger women than in the older women, but the reason for this phenomenon is unclear.
评估使用猪皮胶原植入物(Pelvicol)修复手术后影响盆腔器官脱垂(POP)复发的因素。
2003 年 12 月至 2005 年 8 月,78 例主要为盆腔器官脱垂定量(POP-Q)系统 3 期的患者接受了阴道修复术,使用猪皮植入物。在术前、6 周和 1 年随访时进行评估。这些评估包括 POP-Q、尿失禁影响问卷、泌尿生殖窘迫量表和排便窘迫量表的体格检查以及患者整体改善的问题。记录功能状态、网片侵蚀和不良事件的变化。手术成功定义为 POP-Q 分期 0/1。
71 例患者在 1 年内进行了随访。总体治愈率为 74.6%。年轻组成功手术的机会明显高于老年组(OR:7.5;95%CI 1.38,40.69),但在调整了隔室(后、前、后+前)后,这种效果较低且不再显著(调整 OR:5.5;95%CI 0.92,32.6)。
在一组接受 Pelvicol 修复手术后的女性中,观察到低并发症率和令人满意的总体结果。这些结果是否优于常规手术或不可吸收网片植入术尚不清楚,只能在随机对照试验中确定。年轻女性的结果明显好于老年女性,但原因尚不清楚。