Lo Tsia-Shu, Bt Karim Nazura, Cortes Eileen Feliz M, Wu Pei-Ying, Lin Yi-Hao, Tan Yiap Loong
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Keelung, Keelung Medical Center, Keelung, Taiwan, Republic of China,
Int Urogynecol J. 2015 Mar;26(3):391-400. doi: 10.1007/s00192-014-2492-9. Epub 2014 Sep 26.
The aim of this study was to assess the incidence of de novo stress urinary incontinence (SUI) and sonographic features of implanted transvaginal mesh in continent women treated with Elevate(™) anterior/apical [single-incision mesh (SIM-A)] or Perigee(™) [transvaginal mesh with sacrospinous fixation (TVM + SSF)] in extensive pelvic organ reconstruction surgery.
This prospective observational study was done from May 2010 to January 2013. Patients were recruited from two tertiary centers, and the Elevate(™) and Perigee(™) systems were compared. Patients who had overt or occult SUI, previous prolapse or mesh insertion were excluded.
Fifty-seven patients in the SIM-A group and sixty-one in the TVM + SSF group were analysed. All completed a minimum of 1-year follow-up. Groups were demographically and statistically similar. There was a significantly high incidence of de novo SUI postoperatively in the SIM-A group. The objective and subjective cure rate of pelvic organ prolapse (POP) were comparable between groups, with incidence of mesh erosion in the SIM-A group and three in the TVM + SSF group. Sonographic evaluation showed significant increase in mesh length in the SIM-A group.
Elevate(™) a offered lower incidence of mesh erosion and comparable results on anatomical POP correction; however, incidence of de novo SUI was high. There is an apparent lengthening of implanted Elevate® mesh sonographically.
本研究旨在评估在广泛盆腔器官重建手术中，接受Elevate(™)前位/顶部[单切口网片（SIM-A）]或Perigee(™)[经阴道网片加骶棘肌固定（TVM + SSF）]治疗的无压力性尿失禁（SUI）女性中，新发SUI的发生率以及植入经阴道网片的超声特征。
本前瞻性观察性研究于2010年5月至2013年1月进行。患者来自两个三级中心，对Elevate(™)和Perigee(™)系统进行比较。排除有明显或隐匿性SUI、既往有盆腔器官脱垂或曾植入网片的患者。
分析了SIM-A组的57例患者和TVM + SSF组的61例患者。所有患者均完成了至少1年的随访。两组在人口统计学和统计学上相似。SIM-A组术后新发SUI的发生率显著较高。两组间盆腔器官脱垂（POP）的客观和主观治愈率相当，SIM-A组有[具体数量未给出]例网片侵蚀，TVM + SSF组有3例。超声评估显示SIM-A组网片长度显著增加。
Elevate(™)网片侵蚀发生率较低，在解剖学上对POP矫正的效果相当；然而，新发SUI的发生率较高。超声检查显示植入的Elevate®网片明显延长。
