Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Yonsei Med J. 2009 Dec 31;50(6):807-13. doi: 10.3349/ymj.2009.50.6.807. Epub 2009 Dec 18.
The aim of this study was to evaluate the long-term treatment outcome and major complication rates of abdominal sacrocolpopexy (ASC).
This retrospective study included 57 Korean women who underwent ASC with mesh for symptomatic uterine or vault prolapse and attended follow-up visits for at least 5 years. Forty-seven women with urodynamic stress incontinence concomitantly received a modified Burch colposuspension. The long-term anatomical and functional outcomes and complication rates were assessed.
The median follow-up was 66 months (range 60-108). Overall anatomical success rates (no recurrence of any prolapse >or= stage II according to the pelvic organ prolapse-quantification system) were 86.0%. Urinary urgency and voiding dysfunction were significantly improved after surgery, however, recurrent stress urinary incontinence developed in 44.7% (21/47) of cases and half of them developed within 1-3 months post-op. Bowel function (constipation and fecal incontinence) and sexual function (sexual activity and dyspareunia) did not significantly change after surgery. Major complication requiring reoperation or intensive care developed in 12 (21.0%) cases.
ASC provides durable pelvic support, however, it may be ineffective for alleviating pelvic floor dysfunction except for urinary urgency and voiding dysfunction, and it contains major complication risk that cannot be overlooked.
本研究旨在评估腹式骶骨阴道固定术（ASC）的长期治疗效果和主要并发症发生率。
本回顾性研究纳入了 57 名因子宫或穹窿脱垂而接受 ASC 治疗并接受随访至少 5 年的韩国女性。47 名伴有尿动力学压力性尿失禁的患者同时接受了改良的耻骨后悬吊术。评估了长期的解剖和功能结果以及并发症发生率。
中位随访时间为 66 个月（范围 60-108）。总体解剖成功率（无任何脱垂复发≥盆腔器官脱垂定量系统 II 期）为 86.0%。术后尿急迫和排尿功能障碍明显改善，但 44.7%（21/47）的患者出现复发性压力性尿失禁，其中一半在术后 1-3 个月内发生。术后肠道功能（便秘和粪便失禁）和性功能（性生活和性交痛）无明显变化。需要再次手术或重症监护的主要并发症在 12 例（21.0%）中发生。
ASC 提供持久的骨盆支持，但除了尿急迫和排尿功能障碍外，对缓解盆底功能障碍可能无效，并且存在不可忽视的主要并发症风险。
