Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, OH.
Am J Obstet Gynecol. 2013 Nov;209(5):473.e1-7. doi: 10.1016/j.ajog.2013.05.019. Epub 2013 May 9.
Colpocleisis is a definitive surgical treatment for prolapse resulting in vaginal obliteration. We sought to evaluate body image, regret, satisfaction, and pelvic floor symptoms following this procedure.
This was a prospective multicenter study through the Fellows' Pelvic Research Network. All women electing colpocleisis for management of pelvic organ prolapse were screened for enrollment. The Pelvic Floor Impact Questionnaire, Pelvic Floor Distress Inventory, and the modified Body Image Scale (BIS) were completed preoperatively and 6 weeks following surgery. Additionally, the Decision Regret Scale and the Satisfaction with Decision Scale were administered at the 6-week postoperative visit. A sample size of 88 subjects was calculated to evaluate change in the BIS score.
In all, 87 patients were analyzed. Mean age was 79 years (SD 5.8) with a mean body mass index of 27 (SD 5.3). The majority (89.3%) was Caucasian. Six weeks after surgery, significant improvements were noted in all parameters. Mean BIS scores decreased from 4.8 to 1.2 (P < .001), signifying improved body image. Indeed, the overall number of subjects with BIS scores in the normal range doubled after surgery. Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire scores decreased significantly (P < .001 and P < .001), suggesting a positive impact on bladder, bowel, and prolapse symptoms. Finally, low levels of regret (mean score 1.35) and concurrent high satisfaction (mean score 4.73) were documented.
Colpocleisis improves body image and pelvic floor symptoms while giving patients a definitive surgical option that results in low regret and high satisfaction.
阴道封闭术是一种用于治疗阴道闭锁导致脱垂的确定性手术治疗方法。我们旨在评估该手术治疗后患者的身体意象、后悔感、满意度和盆底症状。
这是一项通过研究员盆底研究网络进行的前瞻性多中心研究。所有选择阴道封闭术治疗盆腔器官脱垂的女性均接受入组筛查。在术前和术后 6 周分别使用盆底影响问卷、盆底窘迫量表和改良身体意象量表（BIS）进行评估。此外，在术后 6 周就诊时还使用决策后悔量表和决策满意度量表进行评估。计算了 88 例患者的样本量，以评估 BIS 评分的变化。
共分析了 87 例患者。平均年龄为 79 岁（SD 5.8），平均体重指数为 27（SD 5.3）。大多数患者（89.3%）为白种人。术后 6 周，所有参数均显著改善。BIS 评分均值从 4.8 降至 1.2（P<.001），表明身体意象得到改善。实际上，术后 BIS 评分正常范围的患者数量增加了一倍。盆底窘迫量表和盆底影响问卷评分显著降低（P<.001 和 P<.001），提示膀胱、肠道和脱垂症状得到改善。最后，记录到低水平的后悔感（平均评分 1.35）和高满意度（平均评分 4.73）。
阴道封闭术可改善身体意象和盆底症状，为患者提供一种确定性的手术选择，同时导致低后悔感和高满意度。
