Department of Obstetrics and Gynaecology, Grenoble University Hospital and University of Grenoble, B.P. 217, 38043 Grenoble Cedex 09, France.
Eur J Obstet Gynecol Reprod Biol. 2011 Jun;156(2):217-22. doi: 10.1016/j.ejogrb.2011.01.022. Epub 2011 Feb 26.
To evaluate the anatomical and functional outcomes of laparoscopic sacrocolpopexy using an anterior and a posterior polyester mesh, for the cure of genital prolapse at one year or longer.
This is a consecutive 5 year prospective observational study in which 119 patients presented with at least a Stage 2 apical prolapse, with an anterior or a posterior vaginal wall prolapse, who underwent a double sacrocolpopexy. Two large pore size (≥ 1mm) heavyweight (115 g/m(2)) multifilaments of polyester prostheses (Parietex Prosup PAC/GK 06, Sofradim-Covidien) were exclusively used for this technique. The prostheses were fixed on the levator ani muscles, the vagina and the sacrum with permanent extracorporeal laparoscopic sutures. Pre- and post-operative data referring to international pelvic organ prolapse quantitation classification (POP-Q), scores of quality of life and sexuality (French equivalent of the Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ) and Pelvic organ prolapse-urinary Incontinence-Sexual Questionnaire (PISQ-12)) were compared.
With a mean follow-up of 34 months, 116 patients were accessible for evaluation. For these patients, the anatomical success rates (Stage 0 or 1) on the apical, anterior or posterior compartments were respectively, 97%, 89% and 98%. On the functional level, all the scores of quality of life and sexuality were improved.
This study confirms the effectiveness of laparoscopic sacrocolpopexy for the repair of the apical compartment prolapse. It also shows its effectiveness for the anterior compartment repair when the cystocele is moderate and limited to a median defect. In our experience, laparoscopic sacrocolpopexy with heavyweight polyester prosthesis is an effective treatment of the posterior defect.
评估使用前后聚酯网进行腹腔镜骶骨阴道固定术治疗生殖器脱垂的解剖和功能结果，随访时间为 1 年或以上。
这是一项连续 5 年的前瞻性观察研究，共纳入 119 例至少存在 2 度 apical 脱垂和/或前/后阴道壁脱垂的患者，行双骶骨阴道固定术。仅使用 2 种大孔径（≥1mm）重weight（115g/m2）多股聚酯假体（Parietex Prosup PAC/GK 06，Sofradim-Covidien）：Parietex Prosup PAC 和 GK 06。假体通过永久的体外腹腔镜缝线固定于提肛肌、阴道和骶骨上。比较术前和术后国际盆腔器官脱垂定量分类（POP-Q）、生活质量和性功能评分（相当于 Pelvic Floor Distress Inventory（PFDI）的法语版、Pelvic Floor Impact Questionnaire（PFIQ）和 Pelvic Organ Prolapse-Urinary Incontinence-Sexual Questionnaire（PISQ-12））。
平均随访 34 个月后，116 例患者可进行评估。对于这些患者，在前、中、后盆腔解剖学成功率（0 或 1 期）分别为 97%、89%和 98%。在功能方面，所有生活质量和性功能评分均得到改善。
本研究证实了腹腔镜骶骨阴道固定术治疗 apical 脱垂的有效性，也证实了在膀胱膨出中等且局限于中央缺陷时治疗前盆腔脱垂的有效性。根据我们的经验，使用重weight 聚酯假体的腹腔镜骶骨阴道固定术是治疗后盆腔缺陷的有效方法。
