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保留子宫手术治疗盆腔器官脱垂的五年疗效:单中心经验

Five-year outcome of uterus sparing surgery for pelvic organ prolapse repair: a single-center experience.

作者信息

Costantini Elisabetta, Lazzeri Massimo, Zucchi Alessandro, Bini Vittorio, Mearini Luigi, Porena Massimo

机构信息

Section of Urology and Andrology, Department of Medical-Surgical Specialties and Public Health, University of Perugia, Perugia, Italy.

出版信息

Int Urogynecol J. 2011 Mar;22(3):287-92. doi: 10.1007/s00192-010-1342-7. Epub 2010 Dec 9.

DOI:10.1007/s00192-010-1342-7
PMID:21152903
Abstract

INTRODUCTION AND HYPOTHESIS

The study aims to report an extended follow-up of our case series of sacrohysteropexy for pelvic organ prolapse (POP).

METHODS

Fifty-five patients with symptomatic POP underwent uterus sparing surgery. All patients were followed up for 1, 3, 6 and 12 months and then annually. Objective success was defined as a well-supported cervix and no vaginal prolapse stage ≥ 2. Subjective success was no prolapse-related symptoms or voiding disorder.

RESULTS

The mean follow-up was 60 ± 34 months. Anterior compartment prolapse (cystocele) stage ≥ 2 was present in four out of 52 patients (7.7%), while posterior compartment prolapse (rectocele) stage ≥ 2 was present in three (5.7%). Voiding symptoms were resolved in 42 out of 45 patients (93.4%) and storage symptoms in 30 out of 36 (83.3%); one patient reported de novo urgency. Sexual activity was maintained in 28 out of 29 patients (95.5%). Four patients showed de novo stress urinary incontinence.

CONCLUSION

Our findings support the use of uterus preservation, with significative objective and subjective outcomes in treating POP.

摘要

引言与假设

本研究旨在报告我们一系列盆腔器官脱垂(POP)骶骨子宫固定术病例的长期随访情况。

方法

55例有症状的POP患者接受了保留子宫的手术。所有患者在术后1、3、6和12个月进行随访,之后每年随访一次。客观成功定义为宫颈得到良好支撑且阴道脱垂分期≥2期的情况不存在。主观成功定义为无脱垂相关症状或排尿障碍。

结果

平均随访时间为60±34个月。52例患者中有4例(7.7%)存在前盆腔脱垂(膀胱膨出)≥2期,3例(5.7%)存在后盆腔脱垂(直肠膨出)≥2期。45例患者中有42例(93.4%)排尿症状得到缓解,36例中有30例(83.3%)储尿症状得到缓解;1例患者出现新发尿急。29例患者中有28例(95.5%)维持了性活动。4例患者出现新发压力性尿失禁。

结论

我们的研究结果支持保留子宫,其在治疗POP方面具有显著的客观和主观疗效。

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本文引用的文献

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Uterus preservation in pelvic organ prolapse surgery.保留子宫在盆腔器官脱垂手术中的应用。
Nat Rev Urol. 2010 Nov;7(11):626-33. doi: 10.1038/nrurol.2010.164.
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Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse.腹腔镜子宫固定术:一种用于治疗子宫阴道膨出的子宫悬吊术的初步结果。
BJOG. 2010 Jan;117(1):62-8. doi: 10.1111/j.1471-0528.2009.02396.x.
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The effectiveness of surgical correction of uterine prolapse: cervical amputation with uterosacral ligament plication (modified Manchester) versus vaginal hysterectomy with high uterosacral ligament plication.
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Uterine sparing surgical methods in pelvic organ prolapse.盆腔器官脱垂中保留子宫的手术方法。
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Effects of Hysterectomy on Sexual Function.子宫切除术对性功能的影响。
Curr Sex Health Rep. 2014;6(4):244-251. doi: 10.1007/s11930-014-0029-3.
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Uterine-preserving POP surgery.保留子宫的盆腔器官脱垂手术
Int Urogynecol J. 2013 Nov;24(11):1803-13. doi: 10.1007/s00192-013-2171-2.
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Changes in female sexual function after pelvic organ prolapse repair: role of hysterectomy.盆腔器官脱垂修复术后女性性功能的变化:子宫切除术的作用。
Int Urogynecol J. 2013 Sep;24(9):1481-7. doi: 10.1007/s00192-012-2041-3. Epub 2013 Jan 30.
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Sacrohysteropexy followed by successful pregnancy and eventual reoperation for prolapse.骶骨子宫固定术后成功妊娠并最终因子宫脱垂再次手术。
Int Urogynecol J. 2012 Jul;23(7):957-9. doi: 10.1007/s00192-011-1631-9. Epub 2011 Dec 17.
子宫脱垂手术矫正的有效性:宫颈切除术联合子宫骶骨韧带折叠术(改良曼彻斯特手术)与经阴道子宫切除术联合高位子宫骶骨韧带折叠术的比较。
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Vaginal surgery for uterine descent; which options do we have? A review of the literature.子宫脱垂的阴道手术;我们有哪些选择?文献综述。
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Conservation of the prolapsed uterus is a valid option: medium term results of a prospective comparative study with the posterior intravaginal slingoplasty operation.保留脱垂子宫是一种可行的选择:一项与经阴道后路吊带成形术对比的前瞻性研究的中期结果
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