Milani Rodolfo, Frigerio Matteo, Cola Alice, Beretta Carlo, Spelzini Federico, Manodoro Stefano
Female Pelvic Med Reconstr Surg. 2018 Jan/Feb;24(1):39-42. doi: 10.1097/SPV.0000000000000403.
Uterosacral ligament (USL) suspension is a safe and effective procedure in terms of anatomical, functional, and subjective outcomes for primary surgical treatment of prolapse.
There has been a renewed interest toward native tissue prolapse repair by vaginal route because of low cost and lack of mesh-related complications. Uterosacral ligaments are considered safe, effective, and durable as suspending structures for primary surgical repair of the apical compartment. Our aim was to evaluate complications, anatomical, functional and subjective outcomes of high USL suspension for primary prolapse repair.
Data of patients who underwent vaginal hysterectomy followed by high USL suspension for pelvic organ prolapse were retrospectively analyzed. Operative data, as well as complications, were recorded. Anatomical recurrence was defined as descent of any compartment stage II or greater according to the Pelvic Organ Prolapse Quantification system. Functional outcomes focused on urinary, bowel, and sexual dysfunctions. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, Wexner, and Patient Global Impression of Improvement questionnaires were collected.
Data of 533 women were analyzed. Mean follow-up was 32 (SD, 19) months (dropout rate, 2.6%). Most frequent complication was ureteral kinking (2.6%). Total recurrence rate was 13.7%, with anterior compartment being the most frequent (9.4%), whereas reoperation for symptomatic prolapse recurrence was required in only 1% of patients. Improvement of urinary incontinence, voiding dysfunction, constipation, and dyspareunia was observed. Overall subjective satisfaction was high (Patient Global Impression of Improvement score, 1.3), ranging from "much improved" to "very much improved."
Uterosacral ligament suspension is a safe and effective procedure in primary surgical treatment of pelvic organ prolapse. Anatomical, functional, and subjective outcomes were very satisfactory, and reoperation rate for recurrence was only 1%.
就子宫脱垂的初次手术治疗的解剖学、功能和主观结果而言，子宫骶骨韧带（USL）悬吊术是一种安全有效的手术。
由于成本低且无网片相关并发症，经阴道途径进行天然组织脱垂修复重新受到关注。子宫骶骨韧带被认为是用于阴道顶端区域初次手术修复的安全、有效且持久的悬吊结构。我们的目的是评估高位子宫骶骨韧带悬吊术用于初次脱垂修复的并发症、解剖学、功能和主观结果。
回顾性分析接受经阴道子宫切除术并随后行高位子宫骶骨韧带悬吊术治疗盆腔器官脱垂患者的数据。记录手术数据以及并发症。根据盆腔器官脱垂定量系统，解剖学复发定义为任何区域下降至II期或更高。功能结果重点关注泌尿、肠道和性功能障碍。收集国际尿失禁咨询委员会尿失禁简表、韦克斯纳问卷和患者总体改善印象问卷。
分析了533名女性的数据。平均随访时间为32（标准差，19）个月（失访率，2.6%）。最常见的并发症是输尿管扭曲（2.6%）。总复发率为13.7%，前盆腔复发最常见（9.4%），而仅1%的患者因症状性脱垂复发需要再次手术。观察到尿失禁、排尿功能障碍、便秘和性交困难有所改善。总体主观满意度较高（患者总体改善印象评分为1.3），范围从“大有改善”到“非常有改善”。
子宫骶骨韧带悬吊术是盆腔器官脱垂初次手术治疗的一种安全有效的手术。解剖学、功能和主观结果非常令人满意，复发再次手术率仅为1%。
