Lucero Monica, Shah Aparna D
Department of Obstetrics and Gynecology, Division of Urogynecology, UMass Medical School, Worcester, Massachusetts, USA.
Clin Obstet Gynecol. 2010 Mar;53(1):26-39. doi: 10.1097/GRF.0b013e3181cd4065.
Although most gynecologists are comfortable performing vaginal hysterectomy in the patient without significant uterovaginal prolapse, vaginal hysterectomy for the prolapsed uterus poses unique challenges and requires an increased awareness of deviations in pelvic anatomy that may result. This review article discusses the background of vaginal hysterectomy performed for uterovaginal prolapse, the pathophysiology of uterovaginal prolapse, preoperative assessment of the patient with uterovaginal prolapse, surgical technique, ureteral anatomy, techniques to avoid injury to the ureter at the time of vaginal hysterectomy for uterovaginal prolapse, and other relevant considerations.
虽然大多数妇科医生对在没有明显子宫阴道脱垂的患者中进行阴道子宫切除术感到得心应手，但针对脱垂子宫的阴道子宫切除术存在独特的挑战，需要对可能出现的盆腔解剖结构偏差有更高的认识。这篇综述文章讨论了针对子宫阴道脱垂进行阴道子宫切除术的背景、子宫阴道脱垂的病理生理学、子宫阴道脱垂患者的术前评估、手术技术、输尿管解剖结构、在针对子宫阴道脱垂进行阴道子宫切除术时避免输尿管损伤的技术以及其他相关注意事项。
