Lin Tzu-Yin, Su Tsung-Hsien, Huang Wen-Chu
Department of Obstetrics and Gynecology, Branch for Women and Children, Taipei, Taiwan.
J Obstet Gynaecol Res. 2010 Oct;36(5):1059-63. doi: 10.1111/j.1447-0756.2010.01267.x. Epub 2010 Aug 17.
To elucidate the outcome of transvaginal pelvic reconstructive surgery using polypropylene mesh (Gynemesh; Ethicon, Somerville, NJ, USA) for patients with pelvic organ prolapse (POP) stage III or IV.
Thirty-nine patients who underwent transvaginal pelvic reconstructive surgery from September 2004 through December 2005 were collected and analyzed. All patients underwent pelvic reconstructive surgery with anterior and posterior colporrhaphy with Gynemesh reinforcement.
The average age of the patients was 64.1 years and average parity was 3.9. Thirty-four patients had Pelvic Organ Prolapse Quantification (POP-Q) stage 0, four patients had stage I, and one patient had stage II at a median follow-up time of 18 months postoperatively. The success rate was 97.4%. Only one patient (2.6%) had recurrent genital prolapse (stage II) postoperatively. Quality of life was evaluated before and after the operations. The mean scores on the Urinary Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) were 5.0 ± 4.6 and 8.7 ± 6.2 before the operation and 3.0 ± 4.7 and 3.2 ± 5.6 after the operation, respectively (P = 0.03 and 0.01). The complication rate was 10.3 %, including one vaginal mesh erosion (2.6%), one dyspareunia (2.6%) and two prolonged bladder drainage (longer than 14 days, 5.1%). The mean duration of postoperative bladder drainage was 2.4 days and mean postoperative hospital stay was 5.1 days. Neither long-term nor major complication was identified.
Transvaginal pelvic reconstructive surgery with polypropylene mesh reinforcement is a safe and effective procedure for POP on 1.5 years' follow- up. It also has positive influence on quality of life.
阐明采用聚丙烯网片（Gynemesh；美国新泽西州萨默维尔市强生公司爱力根分部）对Ⅲ期或Ⅳ期盆腔器官脱垂（POP）患者实施经阴道盆腔重建手术的效果。
收集并分析2004年9月至2005年12月期间接受经阴道盆腔重建手术的39例患者。所有患者均接受了采用Gynemesh加固的前后阴道壁修补术式的盆腔重建手术。
患者的平均年龄为64.1岁，平均产次为3.9次。术后中位随访时间18个月时，34例患者的盆腔器官脱垂定量分期（POP-Q）为0期，4例为Ⅰ期，1例为Ⅱ期。成功率为97.4%。仅1例患者（2.6%）术后出现复发性生殖器脱垂（Ⅱ期）。对手术前后的生活质量进行了评估。术前尿失禁困扰量表-6（UDI-6）和尿失禁影响问卷-7（IIQ-7）的平均得分分别为5.0±4.6和8.7±6.2，术后分别为3.0±4.7和3.2±5.6（P=0.03和0.01）。并发症发生率为10.3%，包括1例阴道网片侵蚀（2.6%）、1例性交困难（2.6%）和2例膀胱引流时间延长（超过14天，5.1%）。术后膀胱引流的平均时间为2.4天，术后平均住院时间为5.1天。未发现长期或严重并发症。
聚丙烯网片加固的经阴道盆腔重建手术在1.5年的随访中是治疗POP的一种安全有效的方法。它对生活质量也有积极影响。
