Division of Urogynecology and Reconstructive Pelvic Surgery, Atlantic Health, 95 Madison Avenue, Morristown, NJ 07962, USA.
Am J Obstet Gynecol. 2010 Nov;203(5):506.e1-6. doi: 10.1016/j.ajog.2010.07.020.
We sought to track objective and subjective outcomes ≥1 year after transvaginal mesh system to correct prolapse.
This was a retrospective cohort study of 120 women who received a transvaginal mesh procedure (Avaulta Solo, CR Bard Inc, Covington, GA). Outcomes were pelvic organ prolapse quantification values; Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores; and a surgical satisfaction survey. "Surgical failure" was defined as pelvic organ prolapse quantification point >0, and/or any reports of vaginal bulge.
Of 120 patients, 116 (97%) were followed up for a mean of 14.4 months (range, 12-30). In all, 74 patients had only anterior mesh, 21 only posterior mesh, and 21 both meshes. Surgical cure rate was 81%. Surgical failure was more common if preoperative point C ≥+2 (35% vs 16%; P = .04). Mesh erosion and de novo pain occurred in 11.7% and 3.3%, respectively. Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores improved (P < .01).
Objective and subjective improvements occurred at ≥1 year, yet failure rates were high when preoperative point C was ≥+2.
我们旨在追踪阴道网片系统治疗脱垂≥1 年后的客观和主观结果。
这是一项回顾性队列研究,纳入了 120 名接受阴道网片手术(Avaulta Solo,CR Bard Inc,Covington,GA)的女性。研究结局包括盆腔器官脱垂定量(POP-Q)值、盆腔器官脱垂生活质量问卷简表(PFIQ-7)、盆腔底部健康问卷简表 20 项(PFDI-20)和手术满意度调查。“手术失败”定义为 POP-Q 点>0 和/或任何阴道膨出报告。
120 例患者中,116 例(97%)平均随访 14.4 个月(范围 12-30 个月)。共有 74 例患者仅行前阴道网片,21 例仅行后阴道网片,21 例同时行前后阴道网片。手术治愈率为 81%。术前 C 点≥+2 的患者中,手术失败更为常见(35%比 16%;P =.04)。网片侵蚀和新发疼痛分别为 11.7%和 3.3%。盆腔器官脱垂生活质量问卷简表、盆腔底部健康问卷简表 20 项和健康状况简表 7 项评分均改善(P <.01)。
≥1 年后,患者的客观和主观情况均得到改善,但术前 C 点≥+2 时失败率较高。