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[采用轻质网片经阴道途径修复 3 - 4 度膀胱膨出的安全性及 12 个月结果]

[Safety and 12-month results on stage 3-4 cystocele repair by the vaginal route using a light-weight mesh].

作者信息

Renaudie J, Brouziyne M, Priou G, Devoldère G, Marie G, de Tayrac R

机构信息

Service de gynécologie-obstétrique, clinique du Colombier, 92, avenue Albert-Thomas, CS 46004, 87060 Limoges cedex 2, France.

出版信息

Prog Urol. 2013 Apr;23(4):237-43. doi: 10.1016/j.purol.2013.01.023. Epub 2013 Mar 7.

Abstract

OBJECTIVE

To assess safety and efficacy at short-term of a light-weight polypropylene mesh (28 g/m2) for stage 3-4 cystocele repair by the vaginal route.

MATERIAL AND METHODS

A multicentric prospective cohort study, performed between 2010 and 2011 in seven centers. Pre-operative assessment included prolapse quantification using the POP-Q. Pre- and postoperative validated symptoms and quality of life questionnaires were used. Main objective was mesh safety. Secondary objectives were anatomical and functional success.

RESULTS

One hundred and eleven patients, with a mean age of 67±9 years, were included in the study, and 94 were included in the analysis (84.7%). In 14 cases (12.8%), it was a secondary surgery. Two intra-operative complications occurred (2.2%). Safety analysis on 86 patients followed up at 12 months (91.5%) has shown satisfaction rate of 98.8% (85/86), mesh contraction rate of 9.3% (8/86), one case of vaginal mesh exposure (1.2%), no cases of pelvic pain and rate of postoperative dyspareunia of 5.5% (3/55). Anatomic success rate on cystocele (Ba point < -1) at short-term was 82/86 (95.3%) and improvement of symptoms and quality of life was highly significant. Five patients (5.3%) were reoperated.

CONCLUSION

Cystocele repair by the vaginal route using a light-weight transobturator polypropylene mesh was safe and efficient at short-term. Long-term data are needed.

摘要

目的

评估一种轻质聚丙烯网片(28克/平方米)经阴道途径修复3 - 4度膀胱膨出的短期安全性和有效性。

材料与方法

2010年至2011年在七个中心进行的一项多中心前瞻性队列研究。术前评估包括使用盆腔器官脱垂定量分期系统(POP - Q)进行脱垂量化。使用术前和术后经过验证的症状及生活质量问卷。主要目标是网片安全性。次要目标是解剖学和功能上的成功。

结果

111例患者纳入研究,平均年龄67±9岁,94例纳入分析(84.7%)。14例(12.8%)为二次手术。发生2例术中并发症(2.2%)。对86例随访12个月的患者(91.5%)进行的安全性分析显示,满意率为98.8%(85/86),网片收缩率为9.3%(8/86),1例阴道网片外露(1.2%),无盆腔疼痛病例,术后性交困难发生率为5.5%(3/55)。短期膀胱膨出(Ba点< - 1)的解剖学成功率为82/86(95.3%),症状和生活质量改善非常显著。5例患者(5.3%)再次手术。

结论

经阴道途径使用轻质经闭孔聚丙烯网片修复膀胱膨出在短期内安全有效。需要长期数据。

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