Schmid Corina, O'Rourke Peter, Maher Christopher
Urogynaecology, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Brisbane, QLD, 4029, Australia.
Int Urogynecol J. 2013 May;24(5):763-7. doi: 10.1007/s00192-012-1926-5. Epub 2012 Sep 14.
A prospective case series to assess the safety and efficacy of laparoscopic sacrocolpopexy for the surgical management of recurrent pelvic organ prolapse (POP) after transvaginal polypropylene mesh prolapse surgery.
Between January and December 2010, women with post-hysterectomy recurrent prolapse (≥ stage 2 POP-Q) after transvaginal polypropylene mesh prolapse surgery were included. Perioperative morbidity and short-term complications were recorded and evaluated. Surgical outcomes were objectively assessed utilising the Pelvic Organ Prolapse Quantification system (POP-Q), the validated, condition-specific Australian Pelvic Floor Questionnaire (APFQ) and the Patient Global Impression of Improvement (PGI-I) at 12 months.
All 16 women in this study had undergone surgery with trocar-guided transvaginal polypropylene mesh kits. In 75% the recurrent prolapse affected the compartment of prior mesh surgery with the anterior (81%) and apical (75%) compartment prolapse predominating. At a mean follow-up of 12 months, all women had resolution of awareness of prolapse, had < stage 2 POP-Q on examination and high levels of satisfaction on PGI-I post surgery. There were no serious peri- or postoperative complications.
This preliminary study suggests that laparoscopic sacrocolpopexy for recurrent prolapse after failed transvaginal mesh surgery is feasible and safe. Further widespread evaluation is required.
一项前瞻性病例系列研究，旨在评估腹腔镜骶骨阴道固定术治疗经阴道聚丙烯网片脱垂手术后复发性盆腔器官脱垂（POP）的安全性和有效性。
纳入2010年1月至12月间经阴道聚丙烯网片脱垂手术后子宫切除术后复发性脱垂（POP-Q分期≥2期）的女性。记录并评估围手术期发病率和短期并发症。在12个月时，使用盆腔器官脱垂定量系统（POP-Q）、经过验证的特定病情澳大利亚盆底问卷（APFQ）和患者总体改善印象（PGI-I）对手术结果进行客观评估。
本研究中的所有16名女性均接受了套管针引导下经阴道聚丙烯网片套件手术。75%的复发性脱垂累及先前网片手术的区域，其中前壁（81%）和顶端（75%）脱垂为主。平均随访12个月时，所有女性脱垂感均消失，检查时POP-Q分期<2期，术后PGI-I满意度高。无严重围手术期或术后并发症。
这项初步研究表明，腹腔镜骶骨阴道固定术治疗经阴道网片手术失败后的复发性脱垂是可行且安全的。需要进一步广泛评估。
