Chrysanthopoulou E L, Pergialiotis V, Perrea D, Κourkoulis S, Verikokos C, Doumouchtsis S K
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece; Department of Obstetrics and Gynaecology, Queen's Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece.
Med Hypotheses. 2017 Jul;104:97-100. doi: 10.1016/j.mehy.2017.05.018. Epub 2017 May 25.
Pelvic organ prolapse (POP) is a major health problem that affects many women with potentially severe physical and psychological impact as well as impact on their daily activities, and quality of life. Several surgical techniques have been proposed for the treatment of POP. The FDA has published documents that refer to concerns about the use of synthetic meshes for the treatment of prolapse, in view of the severe complications that may occur. These led to hesitancy in use of these meshes and partial increase in use of other biological grafts such as allografts and xenografts. Although there seems to be an increasing tendency to use grafts in pelvic floor reconstructive procedures due to lower risks of erosion than synthetic meshes, there are inconclusive data to support the routine use of biological grafts in pelvic organ prolapse treatment. In light of these observations new strategies are needed for the treatment of prolapse. Platelet rich plasma (PRP) is extremely rich in growth factors and cytokines, which regulate tissue reconstruction and has been previously used in orthopaedics and plastic surgery. To date, however, it has never been used in urogynaecology and there is no evidence to support or oppose its use in women who suffer from POP, due to uterine ligament defects. PRP is a relatively inexpensive biological material and easily produced directly from patients' blood and is, thus, superior to synthetic materials in terms of potential adverse effects such as foreign body reaction. In the present article we summarize the existing evidence, which supports the conduct of animal experimental and clinical studies to elucidate the potential role of PRP in treating POP by restoring the anatomy and function of ligament support.
盆腔器官脱垂（POP）是一个重大的健康问题，影响着许多女性，对她们可能产生严重的生理和心理影响，以及对她们的日常活动和生活质量产生影响。已经提出了几种手术技术来治疗POP。鉴于可能发生的严重并发症，美国食品药品监督管理局（FDA）已发布文件提及对使用合成网片治疗脱垂的担忧。这些导致了对这些网片使用的犹豫，以及同种异体移植物和异种移植物等其他生物移植物使用的部分增加。尽管由于侵蚀风险低于合成网片，在盆底重建手术中使用移植物的趋势似乎在增加，但尚无确凿数据支持在盆腔器官脱垂治疗中常规使用生物移植物。鉴于这些观察结果，需要新的策略来治疗脱垂。富含血小板血浆（PRP）极其富含生长因子和细胞因子，这些因子调节组织重建，并且先前已用于骨科和整形外科。然而，迄今为止，它从未用于泌尿妇科，并且没有证据支持或反对在因子宫韧带缺陷而患有POP的女性中使用它。PRP是一种相对便宜的生物材料，很容易直接从患者血液中制备，因此，在诸如异物反应等潜在不良反应方面优于合成材料。在本文中，我们总结了现有证据，这些证据支持进行动物实验和临床研究，以阐明PRP在通过恢复韧带支撑的解剖结构和功能来治疗POP中的潜在作用。
