Aukee Pauliina, Humalajärvi Niina, Kairaluoma Matti V, Valpas Antti, Stach-Lempinen Beata
Department of Obstetrics and Gynecology, Department of Pelvic Floor Research and Therapy Unit, Central Finland Central Hospital, Jyväskylä, Finland.
Department of Obstetrics and Gynecology, Department of Pelvic Floor Research and Therapy Unit, Central Finland Central Hospital, Jyväskylä, Finland.
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:53-56. doi: 10.1016/j.ejogrb.2018.06.008. Epub 2018 Jun 8.
The aim of this study was to evaluate the effect of hysterectomy with or without concomitant prolapse surgery on subject-reported pelvic floor disorders (PFD) with a 5-year follow-up.
This prospective longitudinal study was carried out in two Finnish central hospitals among 286 women who had undergone hysterectomy for benign reasons. The presence of urinary incontinence, urinary frequency, feeling of vaginal bulging, constipation and anal incontinence was evaluated at baseline, 1 and 5 years postoperatively. Analysis was performed on 256 (895%) patients who answered at least one of the follow-up questionnaires.
Hysterectomy with concomitant native tissue prolapse surgery significantly reduced urinary incontinence, urinary frequency, constipation and the feeling of vaginal bulging, and the results were maintained over the following five years. Plain hysterectomy reduced urinary frequency and the feeling of vaginal bulging but did not relieve urinary incontinence. Hysterectomy had no effect on anal incontinence. The total subsequent prolapse and/or incontinence operation rate was 2,7%, and was higher among patients who underwent hysterectomy for pelvic organ prolapse.
During a 5-years follow-up a hysterectomy alone or with native tissue prolapse surgery did not worsen pelvic floor disorders.
本研究旨在通过5年随访评估子宫切除术伴或不伴脱垂手术对患者报告的盆底功能障碍（PFD）的影响。
这项前瞻性纵向研究在芬兰的两家中心医院对286名因良性原因接受子宫切除术的女性进行。在基线、术后1年和5年评估尿失禁、尿频、阴道膨出感、便秘和肛门失禁的情况。对至少回答了一份随访问卷的256名（89.5%）患者进行分析。
子宫切除术伴天然组织脱垂手术显著降低了尿失禁、尿频、便秘和阴道膨出感，且在随后的五年中结果得以维持。单纯子宫切除术降低了尿频和阴道膨出感，但未缓解尿失禁。子宫切除术对肛门失禁无影响。随后的脱垂和/或失禁手术总发生率为2.7%，在因盆腔器官脱垂接受子宫切除术的患者中更高。
在5年随访期间，单纯子宫切除术或联合天然组织脱垂手术并未使盆底功能障碍恶化。
