Lukban James C, Beyer Roger D, Moore Robert D
Division of Urogynecology, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 310, Norfolk, VA 23507, USA.
Obstet Gynecol Int. 2012;2012:354897. doi: 10.1155/2012/354897. Epub 2011 Dec 10.
Introduction and Hypothesis. We sought to determine the mesh extrusion (vaginal exposure) rates and subject outcomes following IntePro (Type I polypropylene) mesh "kit" repairs for vaginal prolapse. Methods. Data were pooled from two prospective multicenter studies evaluating the safety and efficacy of the Perigee and Apogee (American Medical Systems, Minnetonka, Minn, USA) to treat anterior and posterior/apical prolapses, respectively. Extrusions involving the anterior compartment (AC) or posterior compartment/apex (PC/A) were recorded. Results. Two hundred sixty women underwent mesh placement, with a total of 368 mesh units inserted (173 in the AC and 195 in the PC/A). Extrusions were noted in 13 (7.5%) of AC implants and 27 (13.8%) of PC/A implants through 12 months. No difference was seen between those with and without extrusion in regard to anatomic cure, postoperative painor quality of life at 1 year. Conclusions. Extrusion had no apparent effect on short-term outcomes. Given the unknown long-term sequellae of vaginal mesh exposure, a thorough assessment of risks and benefits of transvaginal mesh placement should be considered at the time of preoperative planning.
引言与假设。我们试图确定在使用IntePro(I型聚丙烯)网片“套件”修复阴道脱垂后网片挤出(阴道暴露)率及患者预后。方法。数据来自两项前瞻性多中心研究,分别评估Perigee和Apogee(美国美敦力公司,明尼苏达州明尼通卡)治疗前壁和后壁/顶部脱垂的安全性和有效性。记录涉及前盆腔(AC)或后盆腔/顶部(PC/A)的挤出情况。结果。260名女性接受了网片植入,共植入368个网片单元(AC植入173个,PC/A植入195个)。在12个月时,AC植入物中有13个(7.5%)出现挤出,PC/A植入物中有27个(13.8%)出现挤出。在解剖学治愈、术后疼痛或1年时的生活质量方面,有挤出和无挤出的患者之间没有差异。结论。挤出对短期预后没有明显影响。鉴于阴道网片暴露的长期后遗症尚不清楚,在术前规划时应考虑对经阴道网片植入的风险和益处进行全面评估。