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使用Avaulta Plus补片进行生殖器脱垂修复:功能结果与生活质量

Genital prolapse repair with Avaulta Plus mesh: functional results and quality of life.

作者信息

Thomin A, Touboul C, Hequet D, Zilberman S, Ballester M, Daraï E

机构信息

Department of obstetrics and gynecology, université Pierre et Marie Curie Paris VI, hôpital Tenon Paris, 4, rue de Chine, 75020 Paris, France.

出版信息

Prog Urol. 2013 Apr;23(4):270-5. doi: 10.1016/j.purol.2013.01.016. Epub 2013 Feb 27.

Abstract

PURPOSE

Evaluate anatomic and functional outcomes of genital prolapse repair by vaginal route using a mixed polypropylene and porcine skin mesh.

PATIENTS AND METHODS

Prospective pilot study from January 2009 to January 2011 in the gynecologic department of a tertiary university hospital. Twenty patients with stage II-III genital prolapse underwent anterior wall prolapse repair with anterior Avaulta Plus mesh. Functional results were evaluated using the pelvic floor distress inventory-short form (PFDI-20), the pelvic floor impact questionnaire-7 (PFIQ-7) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual questionnaires (PISQ-12).

RESULTS

No per-operative complications occurred. One postoperative hematoma (5%) occurred requiring a second surgery. At a mean follow-up of 19.7 months, three patients had vaginal mesh exposure (15%) requiring a second surgery for two of them. Of the 20 women, 17 (85%) had optimal anatomic results and three (15%) had residual genital prolapse (Ba=-2 in two cases and Bp = -2 in the one). No recurrence was observed during the study period. A significant improvement in the PFDI-20 (P<0.001) and PFIQ-7 scores (P<0.001) was observed but no improvement in the PISQ-12 score.

CONCLUSION

In this series, we reported that genital prolapse repair using Avaulta Plus mesh resulted in a high success rate and improved quality of life but with an important prevalence of vaginal mesh exposure.

摘要

目的

评估使用聚丙烯和猪皮混合网片经阴道途径修复生殖器脱垂的解剖学和功能学结果。

患者与方法

2009年1月至2011年1月在一所三级大学医院的妇科进行的前瞻性试点研究。20例II - III期生殖器脱垂患者接受了前壁脱垂修复术,使用了前位Avaulta Plus网片。使用盆底困扰量表简表(PFDI - 20)、盆底影响问卷7项(PFIQ - 7)和盆腔器官脱垂/尿失禁性功能问卷(PISQ - 12)评估功能结果。

结果

术中无并发症发生。术后发生1例血肿(5%),需要二次手术。平均随访19.7个月时,3例患者出现阴道网片暴露(15%),其中2例需要二次手术。20名女性中,17例(85%)获得了最佳解剖学结果,3例(15%)存在残留生殖器脱垂(2例Ba = - 2,1例Bp = - 2)。研究期间未观察到复发。PFDI - 20(P < 0.001)和PFIQ - 7评分(P < 0.001)有显著改善,但PISQ - 12评分无改善。

结论

在本系列研究中,我们报告使用Avaulta Plus网片修复生殖器脱垂成功率高,生活质量得到改善,但阴道网片暴露发生率较高。

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