Department of Obstetrics and Gynecology, China Medical University Hospital, Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
Eur J Obstet Gynecol Reprod Biol. 2011 Mar;155(1):106-9. doi: 10.1016/j.ejogrb.2010.12.005. Epub 2011 Jan 5.
The goal of this study was to analyze the potential risk factors of surgical failure after posterior intravaginal slingplasty for uterine or vaginal vault prolapse.
Women with symptomatic uterine or vaginal vault prolapse that extended to or beyond the introitus were eligible for inclusion. Each woman underwent a detailed history taking and a vaginal examination for staging of pelvic organ prolapse before treatment. Follow-up evaluations were at 3, 6, 9, 12, 18, 24, and 30 months after the operation. Surgical failure is defined as the presence of symptomatic uterine or vaginal vault prolapse ≧stage 2 (higher than 0, at the hymen) after posterior intravaginal slingplasty.
The surgical failure rate (8/61) following posterior intravaginal slingplasty was 13.1%. Using univariable logistic regression, C or D point stage IV before surgery was significantly associated with surgical failure of posterior intravaginal slingplasty for uterine or vaginal vault prolapse. Complications (11/61=18%) included vaginal erosion (9.8%), blood loss over 500 ml (4.9%), and perineal pain (3.3%).
Procidentia is a significant risk factor for surgical failure of posterior intravaginal slingplasty, and therefore this procedure should never be used alone in patients with complete uterine or vaginal vault prolapse.
本研究旨在分析阴道后穹窿吊带修补术治疗子宫或阴道穹窿脱垂后手术失败的潜在风险因素。
患有症状性子宫或阴道穹窿脱垂且延伸至或超出阴道口的女性符合纳入标准。每位女性在治疗前均接受详细的病史采集和阴道检查，以对盆腔器官脱垂进行分期。术后 3、6、9、12、18、24 和 30 个月进行随访评估。手术失败定义为阴道后穹窿吊带修补术后存在症状性子宫或阴道穹窿脱垂≧2 期（高于处女膜水平）。
阴道后穹窿吊带修补术后手术失败率（8/61）为 13.1%。使用单变量逻辑回归分析，术前 C 或 D 点 IV 期与子宫或阴道穹窿脱垂阴道后穹窿吊带修补术手术失败显著相关。并发症（11/61=18%）包括阴道侵蚀（9.8%）、出血量超过 500ml（4.9%）和会阴疼痛（3.3%）。
前盆腔脱垂是阴道后穹窿吊带修补术手术失败的显著危险因素，因此对于完全性子宫或阴道穹窿脱垂的患者，该手术不应单独使用。
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