Ridgeway Beri M, Cadish Lauren
*Women's Health Institute, Cleveland Clinic, Cleveland, Ohio †Providence Saint John's Health Center, Santa Monica, California.
Clin Obstet Gynecol. 2017 Jun;60(2):312-323. doi: 10.1097/GRF.0000000000000281.
Uterovaginal prolapse may be treated with or without concomitant hysterectomy. Many patients express interest in uterine-sparing prolapse procedures, for which there are increasing evidence available regarding techniques and outcomes. Uterine-sparing procedures to treat uterovaginal prolapse require a unique set of surgical considerations including uterine abnormalities, possibility of occult malignancy, and future pregnancy. Data, including randomized controlled trials, support the use of sacrospinous hysteropexy. Other prospective trials detailing outcomes following uterosacral hysteropexy, mesh augmented sacrospinous hysteropexy, and sacrohysteropexy are also encouraging.
子宫阴道脱垂的治疗可选择是否同时进行子宫切除术。许多患者对保留子宫的脱垂手术感兴趣,目前关于此类手术技术和疗效的证据越来越多。治疗子宫阴道脱垂的保留子宫手术需要一系列独特的手术考量,包括子宫异常情况、隐匿性恶性肿瘤的可能性以及未来妊娠情况。包括随机对照试验在内的数据支持使用骶棘韧带子宫固定术。其他详细介绍子宫骶骨韧带子宫固定术、网片增强骶棘韧带子宫固定术和骶骨子宫固定术疗效的前瞻性试验结果也令人鼓舞。