Milnerowicz-Nabzdyk Ewa, Zimmer Mariusz
2 Department and Clinic of Obstetrics and Gynaecology, Wroclaw Medical University, Wroclaw, Poland.
Prz Menopauzalny. 2016 Mar;15(1):6-11. doi: 10.5114/pm.2016.58766. Epub 2016 Mar 29.
Pelvic organ prolapse (POP) is treated with a great variety of procedures and none is fully satisfactory. The aim of the study was to introduce and evaluate the effectives of laparoscopic trans teres vault suspension (LTTVS) technique as a new method for POP treatment.
In the years 2013-2014, eight symptomatic women with grades II-IV POP underwent LTTVS procedure. The mean age of patients was 65.25 years (range from 52 to 76 years). The surgery encompassed total hysterectomy, suturing the vagina and fixation of uterosacral ligaments to the vaginal stump, fixation of stumps of round ligaments to the vaginal stump, and fixation of the vaginal stump to the anterior rectus fascia. Mean follow-up was 17.75 months (range from 6 to 27 months).
Eight patients were successfully operated. The symptoms of POP resolved after surgery and subjective quality of life increased. In one case a complication such as common fibular nerve injury appeared; however, it resolved after one month of physiotherapy. The other patient reported radiating pain down the leg after three months. No recurrence of vaginal stump prolapse was observed during the follow-up.
LTTVS is a promising method for POP treatment. Due to repair with the use of native tissues, physiological placement of vaginal stump, and high efficacy it can be considered as an alternative to other POP surgeries. The method requires additional research on larger groups of patients.
盆腔器官脱垂(POP)的治疗方法多种多样,但均不尽人意。本研究的目的是介绍并评估腹腔镜经圆韧带穹窿悬吊术(LTTVS)作为一种新的POP治疗方法的有效性。
2013年至2014年,8例有症状的II-IV级POP女性接受了LTTVS手术。患者的平均年龄为65.25岁(范围从52岁至76岁)。手术包括全子宫切除术、阴道缝合、子宫骶韧带固定于阴道残端、圆韧带残端固定于阴道残端以及阴道残端固定于腹直肌前筋膜。平均随访时间为17.75个月(范围从6个月至27个月)。
8例患者手术成功。POP症状术后缓解,主观生活质量提高。1例出现腓总神经损伤等并发症;然而,经过1个月的物理治疗后症状缓解。另1例患者在术后3个月报告腿部有放射性疼痛。随访期间未观察到阴道残端脱垂复发。
LTTVS是一种有前景的POP治疗方法。由于使用自体组织进行修复、阴道残端的生理位置以及高效性,它可被视为其他POP手术的替代方法。该方法需要对更大规模的患者群体进行进一步研究。