Rogowski A, Bienkowski P, Tosiak A, Jerzak M, Mierzejewski P, Baranowski W
Department of Gynecology and Oncological Gynecology, Military Institute of Medicine, 128 Szaserow Street, 04-141, Warsaw, Poland,
Int Urogynecol J. 2013 Dec;24(12):2087-92. doi: 10.1007/s00192-013-2131-x. Epub 2013 Jun 8.
The aim of the present study was to determine possible correlations between mesh retraction after anterior vaginal mesh repair and de novo stress urinary incontinence (SUI), overactive bladder (OAB), and vaginal pain symptoms.
One hundred and three women with symptomatic prolapse of the anterior vaginal wall, stages 3 and 4 based on the Pelvic Organ Prolapse Quantification (POP-Q) system, underwent Prolift anterior™ implantation. At a 6-month follow-up, the patients were interviewed for de novo SUI, OAB, and vaginal pain, and underwent an introital/transvaginal ultrasound examination to measure the mesh length in the midsagittal plane.
Mesh retraction was significantly larger in a subgroup of patients (n = 20; 19.4 %) presenting de novo OAB symptoms on the follow-up assessment compared with those without this complication (5.0 cm vs. 4.3 cm; p < 0.05). Mesh retraction was also significantly larger in a subgroup of patients (n = 23; 22.3 %) reporting postoperative vaginal pain compared with the women who did not report any postoperative vaginal pain (5.3 cm vs. 4.2 cm; p < 0.01). A significant correlation was found between mesh retraction and the severity of vaginal pain (R = 0.4, p < 0.01). Mesh retraction did not differ between patients with de novo SUI symptoms and those without this complication.
Mesh retraction assessed on ultrasound examination after anterior vaginal mesh repair may correlate with de novo OAB symptoms and vaginal pain.
本研究的目的是确定阴道前壁网片修补术后网片回缩与新发压力性尿失禁（SUI）、膀胱过度活动症（OAB）及阴道疼痛症状之间可能存在的相关性。
103例有症状的阴道前壁脱垂女性，根据盆腔器官脱垂定量（POP-Q）系统评估为3期和4期，接受了Prolift anterior™植入术。在6个月的随访中，对患者进行新发SUI、OAB和阴道疼痛的访谈，并进行阴道口/经阴道超声检查以测量矢状面中网片的长度。
在随访评估中出现新发OAB症状的患者亚组（n = 20；19.4%）中网片回缩明显大于无此并发症的患者（5.0 cm对4.3 cm；p < 0.05）。报告术后阴道疼痛的患者亚组（n = 23；22.3%）中网片回缩也明显大于未报告任何术后阴道疼痛的女性（5.3 cm对4.2 cm；p < 0.01）。发现网片回缩与阴道疼痛严重程度之间存在显著相关性（R = 0.4，p < 0.01）。有新发SUI症状的患者与无此并发症的患者之间网片回缩无差异。
阴道前壁网片修补术后超声检查评估的网片回缩可能与新发OAB症状和阴道疼痛相关。
