Center for Female Pelvic Medicine and Reconstructive Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, OH 44195, USA.
Curr Urol Rep. 2012 Jun;13(3):216-21. doi: 10.1007/s11934-012-0248-y.
Reports in the literature of high recurrence rates after native tissue repair for pelvic organ prolapse led to the development of alternative techniques, such as those using synthetic mesh. Transvaginal mesh (TVM) delivery systems were implemented in search of better outcomes. Despite reported recurrence as low as 7.1 % after posterior colporrhaphy, mesh kits were developed to correct posterior compartment prolapse. There is a paucity of data to substantiate better results with TVM for rectocele repair. Three randomized controlled trials comparing native tissue repair to synthetic mesh reported posterior compartment outcomes and two of these failed to show a significant difference between groups. Complications of TVM placement are not insignificant and mesh extrusion was reported in up to 16.9 %. Based on currently available data, native tissue repairs have similar outcomes to synthetic mesh without the risks inherent in mesh use and remain the standard of care for the typical patient.
文献报道，盆腔器官脱垂患者经固有组织修复后复发率较高，这促使人们开发了替代技术，如使用合成网片。为了获得更好的效果，采用了经阴道网片（TVM）输送系统。尽管阴道后壁修补术的复发率低至 7.1%，但仍开发了网片套件来纠正后盆腔器官脱垂。TVM 修复直肠膨出的结果更好，但数据很少。三项比较固有组织修复与合成网片的随机对照试验报告了后盆腔器官脱垂的结果，其中两项试验未能显示组间有显著差异。TVM 放置的并发症并非微不足道，网片挤出的发生率高达 16.9%。基于现有数据，固有组织修复与合成网片的结果相似，且不存在网片使用固有的风险，因此仍然是典型患者的护理标准。
