Serati Maurizio, Braga Andrea, Cantaluppi Simona, Caccia Giorgio, Ghezzi Fabio, Sorice Paola
Department Obstetrics and Gynecology, Urogynecolgy Unit, University of Insubria, Piazza Biroldi 1, 21100, Varese, Italy.
Department of Obstetrics and Gynecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland.
Int Urogynecol J. 2018 Jun;29(6):831-836. doi: 10.1007/s00192-017-3498-x. Epub 2017 Oct 24.
The aim of this study was to assess the safety and efficacy of vaginal native tissue repair and uterine suspension after a follow-up of at least 1 year.
We included all consecutive women with an anterior vaginal prolapse of stage II or higher and a concomitant uterine prolapse of stage II who underwent this surgical procedure. We considered women with a descensus with maximum point of less than -1 in any compartment as objectively cured. Overall success was defined as no prolapse symptoms, together with a Patient Global Impression of Improvement (PGI-I) score of 2 or less, prolapse of stage lower than II, and no need for other surgery.
A total of 102 patients underwent this surgical procedure during the study period and met all the inclusion criteria for statistical analysis. The mean follow-up was 31 ± 8.2 months; no patient was lost to follow-up. Five patients (4.9%) showed postoperative complications. In terms of subjective outcomes, at the last available follow-up, failure of this surgical procedure was seen in 2% of patients. The objective cure rate and the overall cure rate were the 95.1%. No significant deterioration in objective cure rates was observed over time (p = 0.6).
Vaginal repair and hysteropexy appear to be an effective and safe option for women with advanced uterovaginal prolapse.
本研究旨在随访至少1年后评估阴道原生组织修复及子宫悬吊术的安全性和有效性。
我们纳入了所有连续的患有II期或更高程度阴道前壁脱垂且伴有II期子宫脱垂并接受该手术的女性。我们将任何腔室中最大脱垂点小于-1的脱垂女性视为客观治愈。总体成功定义为无脱垂症状、患者整体改善印象(PGI-I)评分为2或更低、脱垂程度低于II期且无需其他手术。
在研究期间共有102例患者接受了该手术并符合所有纳入统计分析的标准。平均随访时间为31±8.2个月;无患者失访。5例患者(4.9%)出现术后并发症。就主观结果而言,在最后一次可获得的随访中,2%的患者手术失败。客观治愈率和总体治愈率为95.1%。随着时间推移未观察到客观治愈率有显著恶化(p = 0.6)。
对于晚期子宫阴道脱垂的女性,阴道修复和子宫固定术似乎是一种有效且安全的选择。