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经阴道网片治疗盆腔器官脱垂——Prolift+M:一项前瞻性临床试验。

Transvaginal mesh surgery for pelvic organ prolapse--Prolift+M: a prospective clinical trial.

作者信息

Khandwala Salil, Jayachandran Chaandini

机构信息

Division of Urogynecology, Oakwood Hospital and Medical Center, Dearborn, MI, USA.

出版信息

Int Urogynecol J. 2011 Nov;22(11):1405-11. doi: 10.1007/s00192-011-1482-4. Epub 2011 Jul 1.

Abstract

INTRODUCTION AND HYPOTHESIS

This study deals with assessment of safety, efficacy, and potential complications of Prolift+M system to correct uterovaginal prolapse.

METHODS

We analyzed a prospective cohort treated with the Gynecare PROLIFT+M mesh system between October 2008 and March 2010. A composite score that included subjective/objective cure and lack of complications was used to assess treatment success.

RESULTS

One hundred sixty-seven women (age 65.1 ± 11.2 years, BMI 29.2 ± 5.8 kg/m(2)) were treated for pelvic organ prolapse using the PROLIFT+M system. Seven anterior Prolift+M, 42 posterior Prolift+M, and 118 total Prolift+M mesh surgeries were performed in patients with stage II or greater degrees of prolapse. Mean operative time was 122.7 ± 43.9 min. Mean intraoperative blood loss was 119.4 ± 125.3 ml. Our composite success score was 72.5% (treatment failures per POP-Q stage 1.4%, perception of bulge 4.4%, erosions 3.6%, pain/dyspareunia 3.7%, incontinence 0.7%, de novo urge urinary incontinence 8.7%, voiding dysfunction 0.6%, recurrent urinary tract infection 2.2%, and anal incontinence 2.2%).

CONCLUSIONS

Prolift+M surgery is safe and effective with minimal postoperative morbidities.

摘要

引言与假设

本研究旨在评估用于矫正子宫阴道脱垂的Prolift+M系统的安全性、有效性及潜在并发症。

方法

我们分析了2008年10月至2010年3月间接受吉妮柔适Prolift+M网片系统治疗的前瞻性队列。采用包括主观/客观治愈及无并发症的综合评分来评估治疗效果。

结果

167名女性(年龄65.1±11.2岁,体重指数29.2±5.8kg/m²)接受了Prolift+M系统治疗盆腔器官脱垂。对II期或更严重脱垂程度的患者进行了7例前位Prolift+M、42例后位Prolift+M及118例全Prolift+M网片手术。平均手术时间为122.7±43.9分钟。平均术中失血量为119.4±125.3毫升。我们的综合成功评分为72.5%(根据盆腔器官脱垂定量分期系统,治疗失败率为1.4%,膨出感为4.4%,糜烂为3.6%,疼痛/性交困难为3.7%,尿失禁为0.7%,新发急迫性尿失禁为8.7%,排尿功能障碍为0.6%,复发性尿路感染为2.2%,肛门失禁为2.2%)。

结论

Prolift+M手术安全有效,术后发病率极低。

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