Rosati Maurizio, Bramante Silvia, Bracale Umberto, Pignata Giusto, Azioni Guglielmo
Department of Obstetrics and Gynecology, Santo Spirito Hospital, Pescara, Italy.
JSLS. 2013 Apr-Jun;17(2):235-44. doi: 10.4293/108680813X13654754535115.
To evaluate the efficacy of laparoscopic sacrocervicopexy for apical support in sexually active patients with pelvic organ prolapse.
One-hundred thirty-five women with symptomatic prolapse of the central compartment (Pelvic Organ Prolapse Quantitative [POP-Q] stage 2) underwent laparoscopic sacrocervicopexy. The operating physicians used synthetic mesh to attach the anterior endopelvic fascia to the anterior longitudinal ligament of the sacral promontory with subtotal hysterectomy. Anterior and posterior colporrhaphy was performed when necessary. The patients returned for follow-up examinations 1 month after surgery and then over subsequent years. On follow-up a physician evaluated each patient for the recurrence of genital prolapse and for recurrent or de novo development of urinary or bowel symptoms. We define "surgical failure" as any grade of recurrent prolapse of stage II or more of the POP-Q test. Patients also gave feedback about their satisfaction with the procedure.
The mean follow-up period was 33 months. The success rate was 98.4% for the central compartment, 94.2% for the anterior compartment, and 99.2% for the posterior compartment. Postoperatively, the percentage of asymptomatic patients (51.6%) increased significantly (P < .01), and we observed a statistically significant reduction (P < .05) of urinary urge incontinence, recurrent cystitis, pelvic pain, dyspareunia, and discomfort. The present study showed 70.5% of patients stated they were very satisfied with the operation and 18.8% stated high satisfaction.
Laparoscopic sacrocervicopexy is an effective option for sexually active women with pelvic organ prolapse.
评估腹腔镜骶骨宫颈固定术对有性生活的盆腔器官脱垂患者的顶端支持疗效。
135例有中盆腔症状性脱垂（盆腔器官脱垂定量分期[POP-Q]2期）的女性接受了腹腔镜骶骨宫颈固定术。手术医生使用合成网片在次全子宫切除的情况下将盆腔内筋膜前端附着于骶岬前纵韧带。必要时进行前后阴道壁修补术。患者在术后1个月复诊，随后数年也进行复诊。复诊时，医生评估每位患者生殖器脱垂的复发情况以及泌尿或肠道症状的复发或新发情况。我们将“手术失败”定义为POP-Q检查中出现任何II级或更高级别的复发脱垂。患者还对该手术的满意度给出反馈。
平均随访期为33个月。中盆腔成功率为98.4%，前盆腔为94.2%，后盆腔为99.2%。术后，无症状患者的比例（51.6%）显著增加（P < 0.01），并且我们观察到尿急失禁、复发性膀胱炎、盆腔疼痛、性交困难和不适在统计学上有显著减少（P < 0.05）。本研究显示70.5%的患者表示对手术非常满意，18.8%的患者表示高度满意。
腹腔镜骶骨宫颈固定术是有性生活的盆腔器官脱垂女性的有效选择。
