Schär Gabriel
Kantonsspital Aarau, Frauenklinik.
Ther Umsch. 2010 Jan;67(1):31-7. doi: 10.1024/0040-5930/a000007.
It is recommended to perform pelvic floor prolapse surgery within a concept which bases on the women's symptoms, the expectations on life quality and functional aspects of the vagina, urinary bladder and rectum. Decisions on type of surgery must also be founded on the anatomical defect. An apical prolapse should either be fixed by sacrospinous ligament suspension or by sacrocolpopexy. In case of a cystocele the type of defect must be considered; a cystocele with a central defect can be corrected by anterior colporrhaphy whereas the cystocele caused by a paravaginal defect needs lateral fixation which today is increasingly done by vaginal mesh surgery. Rectocele repair is performed by posterior colporrhaphy. Knowledge of success and complication rates is essential for taking the right surgical decisions and for counselling the patient.
建议在基于女性症状、对生活质量的期望以及阴道、膀胱和直肠功能方面的理念下进行盆底脱垂手术。手术类型的决策也必须基于解剖学缺陷。顶端脱垂应通过骶棘韧带悬吊术或骶骨阴道固定术进行修复。对于膀胱膨出，必须考虑缺陷类型；中央缺陷型膀胱膨出可通过阴道前壁修补术纠正，而由阴道旁缺陷引起的膀胱膨出则需要进行侧方固定，如今越来越多地通过阴道网片手术来完成。直肠膨出修补术通过阴道后壁修补术进行。了解成功率和并发症发生率对于做出正确的手术决策以及为患者提供咨询至关重要。
