Detollenaere R J, den Boon J, Kluivers K B, Vierhout M E, van Eijndhoven H W F
Department of Obstetrics and Gynecology, Isala klinieken, PO Box 10500, 8000 GK, Zwolle, The Netherlands.
Int Urogynecol J. 2013 May;24(5):781-8. doi: 10.1007/s00192-012-1934-5. Epub 2012 Sep 22.
To evaluate current practice in the surgical treatment of uterine descent among members of the Dutch Urogynecological Society and to analyze possible trends in the surgical treatment of pelvic organ prolapse in the Netherlands during the last decade.
A questionnaire, including case scenarios, was sent to the members of the Dutch Urogynecological Society. Using a nationwide registry from the Netherlands, we assessed the number and type of surgical procedures performed for pelvic organ prolapse between 1997 and 2009.
The response rate was 73%, with 161 questionnaires completed. Vaginal hysterectomy, sacrospinous hysteropexy, and the Manchester Fothergill procedure were the most frequently performed surgical interventions for uterine descent. In the case of lower stage uterine descent, uterus preservation was preferred, but in the case of higher stage there was wide variation. Two thirds of the respondents stated that in recent years they tended to save the uterus more often. The registered number of hospital admissions for uterine descent increased by 30% between 1997 and 2009 and the number of surgical procedures almost doubled. The number of vaginal hysterectomies performed because of uterine descent increased by only 15% in this period.
In the Netherlands, surgical policy in the case of uterine descent is very variable, with no clear preference for either hysterectomy or uterus preservation. There was a high increase in hospital admissions and pelvic organ prolapse procedures in the last decade. The number of vaginal hysterectomies performed because of uterine descent did not follow this change, which reflects a trend toward preserving the uterus.
评估荷兰泌尿妇科协会成员在子宫脱垂手术治疗方面的当前实践，并分析过去十年荷兰盆腔器官脱垂手术治疗的可能趋势。
向荷兰泌尿妇科协会成员发送了一份包含病例场景的问卷。利用荷兰的全国性登记数据，我们评估了1997年至2009年间盆腔器官脱垂手术的数量和类型。
回复率为73%，共完成161份问卷。阴道子宫切除术、骶棘韧带子宫固定术和曼彻斯特福瑟吉尔手术是子宫脱垂最常实施的手术干预方式。对于较低阶段的子宫脱垂，保留子宫更受青睐，但对于较高阶段则存在很大差异。三分之二的受访者表示，近年来他们更倾向于保留子宫。1997年至2009年间，因子宫脱垂入院的登记人数增加了30%，手术数量几乎翻了一番。在此期间，因子宫脱垂进行的阴道子宫切除术数量仅增加了15%。
在荷兰，子宫脱垂的手术政策差异很大，对于子宫切除术或保留子宫没有明确的偏好。过去十年，入院人数和盆腔器官脱垂手术数量大幅增加。因子宫脱垂进行的阴道子宫切除术数量并未随此变化，这反映了保留子宫的趋势。
