Jacquetin Bernard, Fatton Brigitte, Rosenthal Claude, Clavé Henri, Debodinance Philippe, Hinoul Piet, Gauld Judi, Garbin Olivier, Berrocal Juan, Villet Richard, Salet Lizée Delphine, Cosson Michel
Department of Obstetrics and Gynaecology, Hôtel-Dieu Maternité, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
Int Urogynecol J. 2010 Dec;21(12):1455-62. doi: 10.1007/s00192-010-1223-0. Epub 2010 Aug 4.
To evaluate clinical outcomes at 3 years following total transvaginal mesh (TVM) technique to treat vaginal prolapse.
Prospective, observational study in patients with prolapse ≥ stage II. Success was defined as POP-Q-stage 0-I and absence of surgical re-intervention for prolapse. Secondary outcome measures were: quality of life (QOL), prolapse-specific inventory (PSI), impact on sexual activity and complications.
Ninety women underwent TVM repair, 72 a hysterectomy. Anatomical failure rate was 20.0% at 3 years. Three patients required re-intervention for prolapse. Improvements in QOL- and PSI-scores were observed at 1 and 3 years. Vaginal mesh extrusion occurred in 14.4% patients. After 3 years, 4.7% asymptomatic extrusions remained present. Of 61 sexually active women at baseline, a significant number of patients (41%) ceased sexual activity by 3 years; de novo dyspareunia was reported by 8.8%. One vesico-vaginal fistula resolved after surgery.
Medium-term results demonstrate that the TVM technique provides a durable prolapse repair.
评估经阴道全盆底网状物（TVM）技术治疗阴道脱垂3年后的临床结局。
对脱垂≥Ⅱ期的患者进行前瞻性观察研究。成功定义为盆腔器官脱垂定量分期系统（POP-Q）为0-Ⅰ期且无需因脱垂进行再次手术干预。次要结局指标包括：生活质量（QOL）、脱垂特异性量表（PSI）、对性活动的影响及并发症。
90名女性接受了TVM修复术，72名接受了子宫切除术。3年时解剖学失败率为20.0%。3名患者因脱垂需要再次干预。在1年和3年时观察到QOL和PSI评分有所改善。14.4%的患者出现阴道网状物外露。3年后，4.7%的患者仍有无症状外露。在基线时61名有性活动的女性中，相当数量的患者（41%）在3年前停止了性活动；8.8%的患者报告出现了新发性交困难。1例膀胱阴道瘘术后愈合。
中期结果表明，TVM技术可提供持久的脱垂修复效果。
