Rahkola-Soisalo Päivi, Altman Daniel, Falconer Christian, Morcos Edward, Rudnicki Martin, Mikkola Tomi S
University of Helsinki and Helsinki University Central Hospital, Department of Obstetrics and Gynecology, Finland.
Stockholm Urogynecological Clinic, Sweden; Division of Obstetrics and Gynecology, Karolinska Institutet Danderyd Hospital, Sweden.
Eur J Obstet Gynecol Reprod Biol. 2017 Jan;208:86-90. doi: 10.1016/j.ejogrb.2016.11.011. Epub 2016 Nov 14.
To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold™ System.
In this prospective cohort study, women (n=207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold™ Vaginal Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12. We used odds ratios (ORs) with 95% confidence intervals (CIs) for outcome association analyses using logistic regression.
At one-year follow-up majority of women experienced an overall postoperative improvement in quality of life (p<0.001). One year after surgery Uphold™ operation alone increased the risk for prolapse related bother as compared to Uphold™ combined with anterior colporraphy (POP-IQ-7; OR 2.1; 95% CI 1.01-4.3). The frequency of dyspareunia decreased postoperatively (p=0.004), however, after one-year, overall sexual function deteriorated significantly (p<0.001). The worsening in sexual function scores was mainly attributed to the partner related domain, whereas the behavioral-emotive and physical domains showed no significant changes.
Apical prolapse repair using Uphold™ improved quality of life among our patients but worsened overall sexual function postoperatively.
研究使用Vaginal Uphold™系统对盆腔脏器顶端脱垂手术女性生活质量的影响。
在这项前瞻性队列研究中，对207例有症状的盆腔脏器顶端脱垂女性（无论有无膀胱膨出）使用Uphold™阴道支撑系统进行手术。术后12个月进行生活质量随访，采用PFDI-20、PFIQ-7进行评估，性功能采用PISQ-12进行评估。我们使用比值比（OR）及95%置信区间（CI），通过逻辑回归进行结局关联分析。
在一年的随访中，大多数女性术后生活质量总体改善（p<0.001）。与Uphold™联合前壁修补术相比，单纯Uphold™手术在术后一年增加了脱垂相关困扰的风险（POP-IQ-7；OR 2.1；95% CI 1.01-4.3）。术后性交困难频率降低（p=0.004），然而，一年后，总体性功能显著恶化（p<0.001）。性功能评分恶化主要归因于与伴侣相关的领域，而行为情感和身体领域无显著变化。
使用Uphold™进行盆腔脏器顶端脱垂修复改善了我们患者的生活质量，但术后总体性功能恶化。
