Shippey Stuart H, Quiroz Lieschen H, Sanses Tatiana V D, Knoepp Leise R, Cundiff Geoffrey W, Handa Victoria L
Department of Gynecology and Obstetrics, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Rm A-121, Baltimore, MD 21224-2780, USA.
Int Urogynecol J. 2010 Mar;21(3):279-83. doi: 10.1007/s00192-009-1013-8.
We sought to compare rates of recurrent cystocele following sacrocolpopexy with and without paravaginal repair (PVR).
This retrospective cohort study compared outcomes for patients undergoing sacrocolpopexy with (group A) and without (group B) concomitant PVR. Defining anterior failure as point Ba > or = -1 cm, we compared anatomic outcomes and reoperation rates for recurrence of cystocele.
One hundred seventy patients undergoing sacrocolpopexy had anterior wall prolapse at or beyond the hymen before surgery (62 in group A and 108 in group B). Ten (16.1%) patients in group A and 29 (26.9%) in group B experienced anterior wall prolapse to or beyond -1 cm (p = 0.13, power 0.38). Among these groups, one (1.6%) and five (4.6%) underwent reoperation for cystocele recurrence (p=0.42, power <0.3).
Despite the trend toward improved clinical outcomes, we were unable to detect a statistically significant difference with inclusion of PVR with sacrocolpopexy.
我们试图比较在有或没有阴道旁修补术（PVR）的骶棘韧带固定术后膀胱膨出的复发率。
这项回顾性队列研究比较了接受骶棘韧带固定术并伴有（A组）和不伴有（B组）PVR的患者的结局。将前壁失败定义为Ba点≥ -1 cm，我们比较了膀胱膨出复发的解剖学结局和再次手术率。
170例接受骶棘韧带固定术的患者在手术前有处女膜水平及以上的前壁脱垂（A组62例，B组108例）。A组10例（16.1%）患者和B组29例（26.9%）患者出现前壁脱垂至-1 cm及以下（p = 0.13，检验效能0.38）。在这些组中，1例（1.6%）和5例（4.6%）因膀胱膨出复发接受了再次手术（p = 0.42，检验效能<0.3）。
尽管有临床结局改善的趋势，但我们未能检测到骶棘韧带固定术联合PVR有统计学上的显著差异。
