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[经阴道网片治疗盆腔器官脱垂的现状]

[Current state of transvaginal meshes by resolution of pelvic organ prolapse].

作者信息

Jírová J, Pán M

出版信息

Ceska Gynekol. 2017 Winter;82(1):72-78.

Abstract

OBJECTIVE

Treatment of pelvic organs prolapse with transvaginal mesh kits represents nowadays a widespread surgical method, which partially replaced classic operations due to high success rate and low count of recurrences. Just like any other surgical method, the placement of transvaginal mesh is linked with occurrence of complications. In this article we attempt to review the more and less known facts about trans-vaginal meshes, their efficacy, count of recurrence and the spectrum of complications and we try to compare this technique with traditional surgical methods used to treat pelvic organs prolapse (without graft materials).

DESIGN

Review.

SETTING

Department of Obstetrics and Gynecology, Regional hospital Mladá Boleslav a.s., Mladá Boleslav.

METHODS

Overview of the results of recent studies published in the Czech and English language in recent years.

RESULTS

Pelvic organ prolapse repair with vaginal mesh has generally lower count of relapse especially in patients with wide genital hiatal area and with major levator ani avulsion. The spectrum of complications differs from classical techniques because of the presence of synthetic nonabsorbable material. Some of the specific complications we did not encounter during classical operations include vaginal mesh erosion, infection of mesh associated with chronic pelvic pain, dyspareunia, protrusion of the mesh into the closest organs or the rejection and progressive extrusion of the mesh.

CONCLUSION

Primary enthusiasm has now been replaced with worries of major complications. Future tasks should therefore be aimed at minimizing the rate of complications associated with transvaginal meshes. Except using well-known and safe materials and providing specialized training of physicians for each mesh implantation technique, other precautions outlined in this article should help, such as a closer specification of indication for the application of transvaginal mesh.

摘要

目的

如今,经阴道网片套件治疗盆腔器官脱垂是一种广泛应用的手术方法,因其成功率高且复发率低,部分取代了传统手术。与任何其他手术方法一样,经阴道网片的放置与并发症的发生有关。在本文中,我们试图回顾关于经阴道网片的已知和未知事实、其疗效、复发率以及并发症的范围,并将该技术与用于治疗盆腔器官脱垂的传统手术方法(不使用移植材料)进行比较。

设计

综述。

单位

姆拉达-博莱斯拉夫地区医院妇产科,姆拉达-博莱斯拉夫。

方法

概述近年来以捷克语和英语发表的近期研究结果。

结果

使用阴道网片修复盆腔器官脱垂的复发率通常较低,尤其是在生殖裂孔较宽和肛提肌严重撕裂的患者中。由于存在合成不可吸收材料,并发症的范围与传统技术不同。我们在传统手术中未遇到的一些特定并发症包括阴道网片侵蚀、与慢性盆腔疼痛相关的网片感染、性交困难、网片向最邻近器官突出或网片排斥及逐渐挤出。

结论

最初的热情现在已被对主要并发症的担忧所取代。因此,未来的任务应旨在将与经阴道网片相关的并发症发生率降至最低。除了使用知名且安全的材料并为每位医生提供每种网片植入技术的专业培训外,本文概述的其他预防措施应有所帮助,例如更严格地明确经阴道网片应用的适应证。

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