Rahkola-Soisalo Päivi, Mikkola Tomi S, Altman Daniel, Falconer Christian
Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.
Female Pelvic Med Reconstr Surg. 2019 May/Jun;25(3):200-205. doi: 10.1097/SPV.0000000000000530.
This study aimed to assess the long-term (5 years) outcomes of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse with or without anterior colporraphy.
In total, 164 (81.2%) of 202 women operated on in 24 centers were reached for follow-up. Outcomes were assessed by using the Pelvic Organ Prolapse Quantification, the Pelvic Floor Distress Inventory 20, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire questionnaires. Pain on pelvic area was evaluated using a visual analog scale. Adverse events and secondary procedures were recorded.
An optimal outcome at the apical compartment (Pelvic Organ Prolapse Quantification stage <2) was achieved in 83.3% of patients (94% at 1 year). Quality of life improved in 78.8% of the women, with a significant decrease of bother in all domains (pelvic organ prolapse, rectoanal, urinary) compared with that preoperatively. Overall sexual satisfaction improved after 1 year, but the number of sexually active women was low. In total, 19.7% of patients had undergone repeat pelvic surgery during follow-up, most common of these were midurethral sling (38.4%), followed by prolapse-related operations. Mesh removal due to pain was performed in 3 women. Number of women with any pain decreased overall from 1 to 5 years, but 3 women had persistent severe pain despite treatment efforts (visual analog scale ≥7).
Apical objective and subjective outcomes were sustained after 5 years in women operated on for apical compartment prolapse by the Uphold Vaginal Support System.
本研究旨在评估使用Uphold阴道支撑系统治疗有症状的阴道顶端脱垂伴或不伴前壁修补术的长期（5年）疗效。
在24个中心接受手术的202名女性中，共有164名（81.2%）接受了随访。通过盆腔器官脱垂定量评估、盆底困扰量表20以及盆腔器官脱垂/尿失禁性功能问卷对疗效进行评估。使用视觉模拟量表评估盆腔区域疼痛情况。记录不良事件和二次手术情况。
83.3%的患者（1年时为94%）在顶端区域获得了最佳疗效（盆腔器官脱垂定量分期<2期）。78.8%的女性生活质量得到改善，与术前相比，所有领域（盆腔器官脱垂、直肠肛门、泌尿系统）的困扰均显著减轻。总体性功能满意度在1年后有所改善，但性活跃女性数量较少。共有19.7%的患者在随访期间接受了再次盆腔手术，其中最常见的是中段尿道吊带术（38.4%），其次是与脱垂相关的手术。3名女性因疼痛进行了补片取出术。有疼痛的女性数量总体上从1年到5年有所减少，但仍有3名女性尽管经过治疗仍持续存在严重疼痛（视觉模拟量表≥7）。
对于接受Uphold阴道支撑系统治疗阴道顶端脱垂的女性，5年后顶端区域的客观和主观疗效得以维持。
