Chaturvedi Samit, Bansal Rajesh, Ranjan Priyadarshi, Ansari M S, Kapoor Deepa, Kapoor Rakesh
Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Urol. 2012 Jan;28(1):21-7. doi: 10.4103/0970-1591.94949.
To assess safety, efficacy, and cost-effectiveness of trans-vaginal total pelvic floor repair with customized prolene mesh in patients with high-grade pelvic organ prolapse.
A total of 32 patients, who underwent trans-vaginal total pelvic floor repair using a customized prolene mesh from January 2007 to June 2010 for grade III and IV pelvic organ prolapse, were analyzed retrospectively. Prolapse was graded using Pelvic Organ Prolapse Quantification system of International Continence Society. Patients were evaluated for symptoms associated with prolapse pre- and postoperatively.
Of the 32 patients, 18 were grade IV uterine prolapse, 10 were grade III uterine prolapse, and 4 were grade IV vault prolapse. Twenty-eight patients underwent vaginal hysterectomy at the time of repair. All the patients had associated anterior and posterior prolapse of varying degree. Follow-up ranged from 6 to 42 months. All patients had symptomatic relief after surgery. There were no intraoperative rectal or bladder injuries. Early complications were perineal pain (30), de novo urgency (4), vaginal discharge (3), vaginal wall hematoma (2), and failure to void (2). Two patients had vaginal erosion of mesh.
Trans-vaginal total pelvic floor repair using a customized prolene mesh is safe and effective treatment for comprehensive repair of high-grade pelvic organ prolapse. The use of this custom-made prolene mesh makes the procedure very cost-effective and affordable. The reduction in cost is about 25-30 times with the use of this mesh when compared with commercially available variety.
评估采用定制普理灵网片经阴道全盆底修复术治疗重度盆腔器官脱垂患者的安全性、有效性及成本效益。
回顾性分析2007年1月至2010年6月期间共32例因Ⅲ度和Ⅳ度盆腔器官脱垂采用定制普理灵网片行经阴道全盆底修复术的患者。采用国际尿控协会的盆腔器官脱垂定量系统对脱垂进行分级。对患者术前和术后与脱垂相关的症状进行评估。
32例患者中，18例为Ⅳ度子宫脱垂，10例为Ⅲ度子宫脱垂，4例为Ⅳ度穹隆脱垂。28例患者在修复时行阴道子宫切除术。所有患者均伴有不同程度的前后壁脱垂。随访时间为6至42个月。所有患者术后症状均缓解。术中无直肠或膀胱损伤。早期并发症有会阴部疼痛（30例）、新发尿急（4例）、阴道分泌物（3例）、阴道壁血肿（2例）及排尿困难（2例）。2例患者出现网片阴道侵蚀。
采用定制普理灵网片经阴道全盆底修复术是治疗重度盆腔器官脱垂综合修复的安全有效方法。使用这种定制的普理灵网片使该手术具有很高的成本效益且价格可承受。与市售产品相比，使用这种网片可使成本降低约25至30倍。
