75 岁及以上女性盆底功能障碍的手术治疗：单中心经验。

Surgical treatment for pelvic floor disorders in women 75 years or older: a single-center experience.

机构信息

Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.

出版信息

Menopause. 2011 Mar;18(3):314-8. doi: 10.1097/gme.0b013e3181f2e629.

DOI:10.1097/gme.0b013e3181f2e629

PMID:20861753

Abstract

OBJECTIVE

Older patients are usually regarded as suboptimal candidates for surgical operations, particularly in cases of reparative, non-life-saving procedures. The aim of this study was to analyze the feasibility and safety of surgical treatment for pelvic floor dysfunction in advanced-age women.

METHODS

A single-center descriptive study was performed through a retrospective medical records review. Women 75 years or older who underwent a surgical operation for urogynecological dysfunction (pelvic organ prolapse, urinary incontinence, or both) between January 2000 and December 2009 were considered.

RESULTS

Overall, 138 women were included. Median age was 77 years (range, 75-95 y). Women underwent different types of surgical correction. The following procedures (alone or in combination) were performed: 102 (73.9%) vaginal hysterectomies, 106 (76.8%) anterior repairs, 36 (26%) posterior repairs, 9 (6.5%) colpocleisis, 4 vaginal vault ileococcygeus suspensions (2.9%), and 22 (15.9%) tension-free vaginal tape procedures. One (0.7%) intraoperative and five (3.6%) postoperative complications occurred. Urinary retention rate after surgical operation was 5.8%. Only one (0.7%) woman was discharged with a Foley catheter because of voiding difficulty. Clinical follow-up showed 87.6% anatomical success in women with genital prolapse and a subjective success rate of 86.4% in women undergoing anti-incontinence procedures.

CONCLUSIONS

Our study shows that reconstructive surgical operation is a viable treatment option for pelvic floor dysfunction in older patients.

摘要

目的

老年患者通常被视为手术的次优候选者，尤其是在修复性、非救命手术的情况下。本研究旨在分析对高龄女性盆底功能障碍进行手术治疗的可行性和安全性。

方法

通过回顾性病历审查进行单中心描述性研究。考虑在 2000 年 1 月至 2009 年 12 月期间接受手术治疗尿生殖系统功能障碍（盆腔器官脱垂、尿失禁或两者皆有）的 75 岁或以上女性。

结果

共纳入 138 例女性。中位年龄为 77 岁（范围：75-95 岁）。女性接受了不同类型的手术矫正。实施了以下程序（单独或联合实施）：102 例（73.9%）阴道子宫切除术、106 例（76.8%）前修补术、36 例（26%）后修补术、9 例（6.5%）阴道封闭术、4 例阴道穹窿 ileococcygeus 悬吊术（2.9%）和 22 例（15.9%）经阴道无张力悬吊带术。术中发生 1 例（0.7%）和术后发生 5 例（3.6%）并发症。手术后排尿潴留率为 5.8%。仅有 1 例（0.7%）女性因排尿困难而带 Foley 导管出院。临床随访显示，生殖器脱垂女性的解剖成功率为 87.6%，抗失禁手术女性的主观成功率为 86.4%。